tbuckley/cabot-search huggingface dataset:
The Barefoot Doctors of the People's Republic of China — Some Problems
Authors: Robert C. Hsu
Journal: New England Journal of Medicine (1974)

Abstract Both Western visitors' and official Chinese accounts of China's rural health system indicate that the barefoot doctors have been an unqualified success, free from any problems. Scattered evidence in Chinese publications, however, suggests otherwise. The quality of the barefoot doctors is uneven because of their highly decentralized training and the emphasis placed on their political background. Some barefoot doctors, in spite of their lack of skills, have engaged in medical experiments without professional supervision. All are encouraged by party cadres to develop and use their own herbal medicines. Finally, low income and heavy work load may cause job dissatisfaction, leading to high turnover rates in some areas. Thus, the system of barefoot doctors, although it improved previously inadequate health care in China, is not without its disadvantages and should not necessarily be accepted as a model to emulate. (N Engl J Med 291:124–127, 1974)
Liability in Use of Investigational Drugs
Authors: George E. Schreiner
Journal: JAMA (1963)

RECENT DEVELOPMENTS, including the growth of clinical research centers, the new regulations of the Food and Drug Administration (FDA), and the publicity surrounding the reported adverse reactions to thalidomide have prompted this examination of the moral and legal entanglements facing the clinical investigator. <h3>Purpose of Clinical Investigator</h3> The primary purpose of clinical investigation is to produce scientifically reliable data which will serve to answer specific questions or, simply, to satisfy the investigator's scientific curiosity. Any such investigation, therefore, must be done within the framework of a rational experimental design. Moreover, since the purpose of a drug investigation is to acquire and interpret reliable data which may lead to the proper application of new therapeutic agents, it must include basic, clinical, and therapeutic studies—all of these are necessary if medicine is to advance in knowledge and wisdom. Finally, it is not necessarily the purpose of the clinical investigator to avoid controversy,
IN VITRO STUDIES OF ULCERATIVE COLITIS
Authors: Ove Broberger, Peter Perlmann
Journal: The Journal of Experimental Medicine (1963)

By means of immunofluorescent methods it has been shown that sera from children with ulcerative colitis contain antibodies which react with fetal colon cells in tissue culture. 5 out of 13 sera from patients reacted positively when tested for staining antibodies while 12 sera from healthy individuals yielded negative results. The specificity of the staining reactions was confirmed by inhibition experiments. The staining capacity of various sera was correlated to their hemagglutinating titer when tested against phenol-water extracts of human colon. The presence of blood group substances of the ABO system on fetal colon cells in tissue culture could be demonstrated by application of fluorescent H agglutinins from eel. Cross-inhibition experiments indicated that the H agglutinins stained colon antigens which were different from those reacting with the antibodies of ulcerative colitis sera. The reactivity of cultured fetal colon cells with the antibodies in ulcerative colitis sera was retained for up to 12 days, with optimal staining at 4 to 5 days. Reactivity with H agglutinins was present for a longer period, sometimes more than 20 days. Although antigen could be shown to be present on fetal colon cells in tissue culture, exposure of the culture, in the presence of fresh guinea pig serum, to sera from patients with ulcerative colitis did not lead to any visible cytotoxic damage. In order to investigate the possible cytotoxic effect of the sera with a more sensitive technique, freshly explanted fetal colon was dispersed by trypsinization and the cells labeled with 32P-orthophosphate. Subsequently, these cells were exposed to sera, in a final concentration of 30 per cent, from patients or healthy controls in the presence of fresh guinea pig serum (final concentration 15 per cent). Approximately 20 per cent of the cellular isotope was released into the medium within 150 minutes of incubation, but the release was the same in the samples treated either with patients' sera or normal control sera. Thus, under the present conditions, the patients' sera did not exert any specific cytotoxic action on colon cells.
A TEST TUBE GUARD
Authors: J. Robertson Knowles
Journal: JAMA (1941)

Any one who has occasion to examine urines, and especially a person who heats Benedict solution over a Bunsen burner or an alcohol lamp, knows how easy it is to have the solution boil up and, with considerable force, go all over the wall or surrounding objects. For that reason I have devised a guard for a test tube which is simple, can be easily made, is inexpensive and gives perfect protection. The guard, as may be seen in the accompanying illustration, is made of an ordinary large light teaspoon, by means of a pair of tin clippers. The handle is cut off from the spoon, which leaves the bowl of the spoon together with 1½ inches of the stem. The bowl of the spoon is then bent down, with the concave surface facing downward. The stem of the spoon is then soldered to a tin spring, which can be
Correction: Table in Article on Carotid Bruits
Authors: Seymour N. Herschberg
Journal: Annals of Internal Medicine (1990)

Letters and Corrections15 June 1990Correction: Table in Article on Carotid BruitsSeymour N. Herschberg, MDSeymour N. Herschberg, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-12-967_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:I was very interested in the article by Van Ruiswyk and colleagues (1), but extremely disturbed by what appears to be carelessness in reporting mathematical data. For example, the authors indicate that 12% of their population had asymptomatic carotid bruits, but Table 3 indicates only 21 of 241 residents had such a bruit. Moreover, simple inspection indicates that only a small group, that is those over 95 years of age, had a prevalence greater than 12%-and only marginally so. It is obvious merely from inspection of the table that there could not be a 12% incidence of...Reference1. Van RuiswykNobleSigmann JHP. The natural history of carotid bruits in elderly persons. Ann Intern Med. 1990;112:340-3. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Francis Medical Center Trenton NJ 08629-1986 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1990Volume 112, Issue 12Page: 967-967KeywordsResearch design Issue Published: 15 June 1990 PDF downloadLoading ...
Over-the-Counter Chromium and Renal Failure
Authors: Barry Mennen
Journal: Annals of Internal Medicine (1997)

Letters15 October 1997Over-the-Counter Chromium and Renal FailureBarry Mennen, MDBarry Mennen, MDChromium Information Bureau, Inc.; New York, NY 10028Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-8_Part_1-199710150-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Wasser and colleagues [1] suggest that trivalent chromium taken as a supplement for 6 weeks at 600 µg/d was responsible for a case of chronic active interstitial nephritis in a 49-year-old woman with hypertension. Although renal tubular damage has been described for such persons as welders of stainless steel, who are chronically exposed to water-soluble hexavalent chromium, there has never been a report of renal damage associated with dietary (trivalent) chromium in humans or animals [2] -even when animals received massive daily doses for 6 months [3]. In their review of chromium toxicity, Katz and Salem [2] ...References1. Wasser WG, Feldman NS, D'Agati VD. Chronic renal failure after ingestion of over-the-counter chromium picolinate [Letter]. Ann Intern Med. 1997; 126:410. Google Scholar2. Katz SA, Salem H. The toxicology of chromium with respect to its chemical speciation: a review. J Appl Toxicol. 1993; 13:217-24. Google Scholar3. Anderson RA, Bryden NA, Polansky MM. Lack of toxicity of chromium chloride and chromium picolinate. Toxicologist. 1996; 30:299. Google Scholar4. McKinney TD. Tubulointerstitial diseases and toxic nephropathies. In: Bennett JC, Plum F, eds. Cecil Textbook of Medicine. 20th ed. Philadelphia: WB Saunders; 1996:580-9. Google Scholar5. Subcommittee on the Tenth Edition of the RDAs. Trace elements. In: Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Pr; 1989:241-3. Google Scholar Author, Article, and Disclosure InformationAuthors: Barry Mennen, MDAffiliations: Chromium Information Bureau, Inc.; New York, NY 10028 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCorrelation of blood Cr(III) and adverse health effects: Application of PBPK modeling to determine non-toxic blood concentrationsToxicology of Chromium(III)Scientific Opinion on the safety of chromium picolinate as a source of chromium added for nutritional purposes to foodstuff for particular nutritional uses and to foods intended for the general populationChromium picolinate, zinc picolinate and zinc picolinate dihydrate added for nutritional purposes in food supplementsThe nutritional supplement chromium picolinate generates oxidative DNA damage and peroxidized lipids in vivoDrugs and nutrition 15 October 1997Volume 127, Issue 8_Part_1Page: 655-656 ePublished: 15 August 2000 Issue Published: 15 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Bush legislates for $15bn to be spent on AIDS
Authors: S. Gottlieb
Journal: BMJ (2003)

President Bush signed into law a $15bn (£9.2bn; €12.8bn) programme to help fight AIDS in poor countries in Africa and the Caribbean. He called the scheme “a great mission of rescue.”

The programme, announced in the president's state of the union address in January, is designed to triple investment by the United States in international AIDS help during the next five years.

Although the law envisages subsidies worth $3bn a year through to 2008, it is uncertain how much will actually be spent. The congressional appropriations process for next year is in the early stages, and members of both parties have cautioned that it could be difficult to fit that sum within the limits on foreign aid that Congress has approved.

Mr Bush has also been criticised for not channelling all the …
Dementia in the Elderly: An Analysis of Medical Responsibility
Authors: CHRISTINE K. CASSEL
Journal: Annals of Internal Medicine (1981)

Chronic dementia syndromes are often assumed to be untreatable, and thus patients with these disorders are neglected and their condition worsens. Many interventions, however, can improve the functional capacity of these persons, and thus their abandonment has no ethical justification. Analysis of this problem points to psychological, educational, and institutional barriers responsible for the inadequate care of the demented. Physicians have the ability and power, and therefore the responsibility, to improve this situation.
Primary Aortic Thrombosis
Authors: H. GAYLIS
Journal: Circulation (1958)

Primary arterial thrombosis is a rare lesion and may be defined as thrombosis of a vessel without any obvious underlying cause. The condition has been described in the peripheral arteries of the upper and lower extremities but there are few authenticated reports of the condition affecting the aorta. A case of primary aortic thrombosis occurring in a man aged 32 is reported.
Influence of ethnicity in the outcome of hepatitis C virus infection and cellular immune response
Authors: Kazushi Sugimoto, Jason Stadanlick, Fusao Ikeda, Colleen Brensinger, Emma E. Furth, Harvey J. Alter, Kyong-Mi Chang
Journal: Hepatology (2003)

This study was performed to examine the immunologic basis for the apparent ethnic difference in clinical outcome of hepatitis C virus (HCV) infection between African Americans (AA) and Caucasian Americans (CA). To this end, we recruited 99 chronically HCV–infected and 31 spontaneously HCV–cleared subjects for clinical, virologic, and immunologic analysis. In particular, CD4–proliferative T–cell response to genotype 1-derived HCV antigens (core, NS3–NS5) was examined in 82 patients chronically infected with genotype 1 (54 AA, 28 CA) and in all HCV–cleared subjects (14 AA, 17 CA). HCV–specific Th1 response also was examined in 52 chronic and 13 recovered subjects. Our results showed that HCV clearance was associated with a vigorous HCV–specific Th1 response irrespective of ethnic origin. Although the HCV–specific CD4 T–cell response clearly was weaker during chronic infection, AA ethnicity in this setting was associated with a significantly greater CD4–proliferative T–cell response to HCV, particularly to the nonstructural antigens (22% AA vs. 0% CA, P = .007) as well as better clinical parameters of liver disease. Interestingly, most HCV–specific CD4 T–cell proliferative responses in AA patients were unaccompanied by concurrent interferon γ (IFN–γ) production, suggesting a dysregulated virus–specific, CD4 T–cell effector function during chronic HCV infection. In conclusion, our results suggest that host ethnicity does influence the clinical outcome and antiviral T–cell response during HCV infection. AA ethnicity is associated with a more robust antiviral CD4 T–cell response than CA ethnicity, although these T cells are limited in direct virus or disease control due to their dysfunctional nature.
Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?
Authors: D. H Taylor, A. Esmail
Journal: BMJ (1999)

<h3>abstract</h3> <b>Objectives</b>: To determine the number and geographical distribution of general practitioners in the NHS who qualified medically in South Asia and to project their numbers as they retire. <b>Design</b>: Retrospective analysis of yearly data and projection of future trends. <b>Setting</b>: England and Wales. <b>Subjects</b>: General practitioners who qualified medically in the countries of Bangladesh, India, Pakistan, and Sri Lanka and who were practising in the NHS on 1 October 1992. <b>Main outcome measures</b>: Proportion and age of general practitioners who qualified in South Asia by health authority; the Benzeval and Judge measure of population need at the health authority level. <b>Results</b>: 4192 of 25 333 (16.5%) of all unrestricted general practitioners practising full time on 1 October 1992 qualified in South Asian medical schools. The proportion varied by health authority from 0.007% to 56.5%. Roughly two thirds who were practising in 1992 will have retired by 2007; in some health authorities this will represent a loss of one in four general practitioners. The practices that these doctors will leave seem to be in relatively deprived areas as measured by deprivation payments and a health authority measure of population need. <b>Conclusion</b>: Many general practitioners who qualified in South Asian medical schools will retire within the next decade. The impact will vary greatly by health authority. Those health authorities with the greatest number of such doctors are in some of the most deprived areas in the United Kingdom and have experienced the most difficulty in filling vacancies. Various responses will be required by workforce planners to mitigate the impact of these retirements.
Every psychiatric ward should have a lead consultant, DoH says
Authors: L. Eaton
Journal: BMJ (2002)

England's psychiatric wards should have their own dedicated lead consultant, rather than a team of consultants, none of whom has specific responsibility for the way a ward operates, a report out this week from the Department of Health urges. The guidance on care of adult acute inpatients, issued this Tuesday, is candid about the poor standards of care in many of the country's psychiatric hospitals. In particular, it acknowledges that patients have reported:
Expert witnesses should deliver services through the NHS
Authors: Clare Dyer
Journal: BMJ (2006)

Proposals for far reaching changes to the way expert witnesses provide their services to the family courts in England and Wales were outlined this week in a long awaited report from Liam Donaldson, the chief medical officer for England.

Professor Donaldson recommends that rather than contracting individually with solicitors, experts should deliver their services through the NHS as a core part of its child protection work.

He was asked by ministers in 2004 to come up with ideas to tackle the shortage of medical experts, particularly paediatricians, …
Alexithymic Asthmatics: The Miscommunication of Affective and Somatic States
Authors: Eric L. Brown, Jolene T. Fukuhara, Robert J. Feiguine
Journal: Psychotherapy and Psychosomatics (1981)

The affective and somatic response of alexithymic patients to their asthma was analyzed in reference to the ten symptom categories of the Asthma Symptom Checklist. Alexithymic asthmatics minimize their self-account of physical and emotional difficulties experienced during respiratory distress. Successful medical treatment of these patients necessitates early appraisal of the alexithymic trait followed by an appreciation of the potential psychomaintenance problems which this psychologic condition creates.
New perspectives on epidermal barrier dysfunction in atopic dermatitis: Gene–environment interactions
Authors: Michael J. Cork, Darren A. Robinson, Yiannis Vasilopoulos, Adam Ferguson, Manar Moustafa, Alice MacGowan, Gordon W. Duff, Simon J. Ward, Rachid Tazi-Ahnini
Journal: Journal of Allergy and Clinical Immunology (2006)
Increased concentrations of tumour necrosis factor (TNF) and soluble TNF receptors in biliary obstruction in mice; soluble TNF receptors as prognostic factors for mortality.
Authors: M H Bemelmans, J W Greve, D J Gouma, W A Buurman
Journal: Gut (1996)

Systemic tumour necrosis factor (TNF) is present in jaundiced mice. Two soluble TNF receptors, sTNFr-P55 and sTNFr-P75 are reported to play a part in the natural defence against TNF. This study investigated the properties of circulating TNF and sTNFr in jaundiced mice. The data show that TNF in these mice is biologically inactive and that an increase of both sTNFr is seen (p < 0.001). Surgical trauma in jaundiced mice is known to be accompanied by a high mortality (36%) and increased TNF concentrations. This study shows that both systemic TNF and sTNFr concentrations are increased after surgical trauma in jaundiced mice and that sTNFr concentrations rather than TNF concentrations were found to be correlated with mortality. In line with this finding this study showed that lactulose pretreatment before a surgical trauma in these mice significantly reduces postoperative concentrations of sTNFr-P75 (p < 0.005) and mortality (0%; p < 0.05) without reducing TNF concentrations, while anti-TNF antibodies were ineffective. In conclusion, these data suggest that TNF in biliary obstruction is rapidly inactivated by increased concentrations of sTNFr. Furthermore, sTNFr concentrations rather than TNF concentrations show a good correlation with mortality after surgery in obstructive jaundice. The positive effect of lactulose on mortality could be caused by a decreased inflammatory status.
Austerity measures hit the sickest hardest
Authors: D. Taylor-Robinson, R. Gosling, D. Harrison, M. Khan, B. Barr
Journal: BMJ (2013)

Torjesen highlights the stark inequality in life expectancy shown on the Longer Lives website (http://longerlives.phe.org.uk/).1 The north of England is coloured red and labelled with the “worst” premature mortality, whereas the green fields of the south …
Inhibition of accelerated coronary atherosclerosis with dehydroepiandrosterone in the heterotopic rabbit model of cardiac transplantation.
Authors: D M Eich, J E Nestler, D E Johnson, G H Dworkin, D Ko, A S Wechsler, M L Hess
Journal: Circulation (1993)

BACKGROUND Accelerated coronary atherosclerosis has become a critical problem in cardiac transplantation. Although the pathogenesis of this disease is unknown, hypercholesterolemia has been shown to be a major risk factor. METHODS AND RESULTS To study this problem, a hypercholesterolemic rabbit model of heterotopic cardiac transplantation was developed to study accelerated graft atherosclerosis. Based on suggestions in the literature, it was hypothesized that dehydroepiandrosterone (DHEA) may retard the progression of the disease. Using semiquantitative light microscopy, a predilection for the development of small vessel occlusive disease in the transplanted hearts was found. Chronic DHEA administration produced a 45% reduction in the number of significantly stenosed vessels in the transplanted hearts (p &lt; 0.05) compared with controls and a 62% reduction in the nontransplanted hearts (p &lt; 0.05), yielding an overall 50% reduction in the number of significantly stenosed vessels in both the transplanted and nontransplanted hearts. This reduction in luminal stenosis was observed in the absence of any significant alterations in lipid profiles. CONCLUSIONS It is concluded that chronic DHEA administration in a hypercholesterolemic rabbit model of heterotopic cardiac transplantation significantly retards the progression of accelerated atherosclerosis in both the transplanted heart and in the native heart.
THE TREATMENT OF ANKYLOSTOMIASIS WITH BETA-NAPHTHOL AND THYMOL
Authors: H. G. Phippen
Journal: BMJ (1923)

THE following notes on the treatment for ankylostomiasis which I have carried out for the past eighteen months in Zanzibar and Pemba, where the disease is very prevalent and known as " safuri " and " baridi," may be worth recording.If the patients are debilitated and anaemic, as the majority are, before commencing the treatment proper I give them thrice daily a tonic containing ferri et ammon.citr., liquor
Vectorcardiographic Studies in Acquired Valvular Disease with Reference to the Diagnosis of Right Ventricular Hypertrophy
Authors: J. CUETO, H. TOSHIMA, G. ARMIJO, N. TUNA, C. WALTON LILLEHEI
Journal: Circulation (1966)

The orthogonal vectorcardiogram described by Schmitt and Simonson has been studied in 37 patients with "pure" mitral stenosis. The diagnosis of right ventricular hypertrophy (RVH) could be established from changes in the magnitude, azimuth, and elevations of the initial, middle, and terminal forces, which could not be detected by the routine 12-lead electrocardiogram. This type of [see figure in the PDF file] recording has proved to be of great value in the diagnosis of right ventricular hypertrophy, particularly when the hypertrophy is of mild or moderate degree. Analysis of the instantaneous vectors has proved to be the single most important criterion in the electrocardiographic diagnosis of right ventricular hypertrophy.