tbuckley/cabot-search huggingface dataset:
Cytogenetic studies in human populations exposed to gas leak at Bhopal, India.
Authors: B B Ghosh, S Sengupta, A Roy, S Maity, S Ghosh, G Talukder, A Sharma
Journal: Environmental Health Perspectives (1990)

Frequencies of chromosomal abnormalities, sister chromatid exchanges, and replicative index were assessed following peripheral lymphocyte culture in 129 individuals from Bhopal, India. Of these, 83 persons (40 male and 43 female) had been exposed directly to the methyl isocyanate (MIC) gas after the accident at the Union Carbide plant on December 2 and 3, 1984. The remaining 46 samples were taken from age-matched unexposed persons in the same city. Chromosome aberrations were recorded at first cycle metaphase (M1) and sister chromatid exchanges, at second cycle metaphase (M2), following standard schedule. The frequency of chromosomal aberrations was, in general, higher in individuals from the exposed populations, with the females showing a higher incidence. Nondisjunction of chromosomes or laggard was rare. The frequencies of sister chromatid exchanges and depression in mitotic and replicative indices could not be related to exposure or sex. The persistence of chromosomal abnormalities in the form of replicating minutes and exchange configurations, even 1114 days after exposure to the gas, may indicate a residual effect on T-cell precursors.
Review finds child experts disagreed in 47 cases out of 5000
Authors: Clare Dyer
Journal: BMJ (2004)

The government launched a high level official inquiry last week into the use of expert witnesses in child abuse cases, in the face of a shortage of paediatricians willing to undertake court work.

Margaret Hodge, the children's minister, announced that the chief medical officer for England, Professor Liam Donaldson, would look at the competencies required to give expert evidence in the family courts, and ways of remedying the dearth of paediatricians, paediatric pathologists, and other experts who will agree to do the work.

The move comes amid what seems to be a …
Misleading Second-Stage Schilling Tests Due to Inactive Intrinsic Factor Concentrate
Authors: BRUCE E. JACOBSON
Journal: Annals of Internal Medicine (1979)

Brief Reports1 October 1979Misleading Second-Stage Schilling Tests Due to Inactive Intrinsic Factor ConcentrateBRUCE E. JACOBSON, M.D., GERALD R. ONSTAD, M.D.BRUCE E. JACOBSON, M.D.Search for more papers by this author, GERALD R. ONSTAD, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-4-579 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe second-stage Schilling test (performed with intrinsic factor from hogs) is used to distinguish pernicious anemia from intestinal disorders such as Crohn's disease. We reviewed our experience with the second-stage test and found that inactive intrinsic factor caused the results to be misleading.Eleven consecutive patients who were given a second-stage test are reported. The diagnosis of pernicious anemia was established in all 11 cases by demonstrating B12 deficiency and excluding other possible causes. Those who were recalled for additional absorption studies gave informed consent.Vitamin B12 absorption was tested by measuring radioactivity in plasma (1) and in urine. After...References1. NELPMCAFEEWAGNER WJH. Single measurement of plasma radioactive vitamin B12 as a test for pernicious anemia. J Lab Clin Med. 1963;61:158-65. MedlineGoogle Scholar2. MCDONALDBARRBARTON JRW. Spurious Schilling test results obtained with intrinsic factor enclosed in capsules. Ann Intern Med. 1975;83:827-9. LinkGoogle Scholar3. LINDENBAUMPEZZIMENTISHEA JJN. Small-intestinal function in vitamin B12 deficiency. Ann Intern Med. 1974;80:326-31. LinkGoogle Scholar4. . FDA Enforcement Rep. 1978; 14 June: 4. Google Scholar5. KATZVASDANCEY MMJ. Spurious results of Schilling tests with Frosst intrinsic factor. Can Med Assoc J. 1977;117:27. Letter. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: BRUCE E. JACOBSON, M.D.; GERALD R. ONSTAD, M.D.Affiliations: Hennepin County Medical Center University of Minnesota Medical School Minneapolis, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMagnesium hydrogen breath test using end expiratory sampling to assess achlorhydria in pernicious anaemia patients.Clinical evaluation of simultaneously administered58Co labelled vitamin B 12 and57Co labelled vitamin B 12 bound to intrinsic factor in patients with pernicious anaemiaThe Schilling TestRALPH CARMEL, M.D. 1 October 1979Volume 91, Issue 4Page: 579-580KeywordsBlood plasmaCrohn's diseasePernicious anemiaUrine ePublished: 1 December 2008 Issue Published: 1 October 1979 PDF downloadLoading ...
Our favourite drug
Authors: A. Paton
Journal: BMJ (2002)

Failure to develop a national strategy against alcohol misuse should encourage local initiatives 

Alcohol watchers must surely be aware by now that no political party intends to do anything about alcohol misuse. Repeated calls for a national alcohol policy have been rebuffed since at least the 1980s, and successive ministers have dismissed the need for action on the grounds that the public is happy, in fact the more alcohol the merrier. It is only fair to say that Health of the Nation did set a modest target of a one third reduction in the numbers of people drinking over sensible limits by 2005.1 Ten years on, the number of heavy drinkers has increased. Initiatives from Europe have fared no better. In 1993, Britain was one of the 26 member states that agreed in principle to a 25% reduction in alcohol consumption by the end of the century.2 The government must have known that such a step was a non-starter, given its reliance on alcohol taxes, a commitment to increasing …
Intersexuality and the Cricket Frog Decline: Historic and Geographic Trends
Authors: Amy L. Reeder, Marilyn O. Ruiz, Allan Pessier, Lauren E. Brown, Jeffrey M. Levengood, Christopher A. Phillips, Matthew B. Wheeler, Richard E. Warner, Val R. Beasley
Journal: Environmental Health Perspectives (2004)

Exposure to anthropogenic endocrine disruptors has been listed as one of several potential causes of amphibian declines in recent years. We examined gonads of 814 cricket frogs (Acris crepitans) collected in Illinois and deposited in museum collections to elucidate relationships between the decline of this species in Illinois and the spatial and temporal distribution of individuals with intersex gonads. Compared with the preorganochlorine era studied (1852-1929), the percentage of intersex cricket frogs increased during the period of industrial growth and initial uses of polychlorinated biphenyls (PCBs) (1930-1945), was highest during the greatest manufacture and use of p,p-dichlorodiphenyltrichloroethane (DDT) and PCBs (1946-1959), began declining with the increase in public concern and environmental regulations that reduced and then prevented sales of DDT in the United States (1960-1979), and continued to decline through the period of gradual reductions in environmental residues of organochlorine pesticides and PCBs in the midwestern United States (1980-2001). The proportion of intersex individuals among those frogs was highest in the heavily industrialized and urbanized northeastern portion of Illinois, intermediate in the intensively farmed central and northwestern areas, and lowest in the less intensively managed and ecologically more diverse southern part of the state. Records of deposits of cricket frog specimens into museum collections indicate a marked reduction in numbers from northeastern Illinois in recent decades. These findings are consistent with the hypothesis that endocrine disruption contributed to the decline of cricket frogs in Illinois.
Genomic surveys by methylation-sensitive SNP analysis identify sequence-dependent allele-specific DNA methylation
Authors: Kristi Kerkel, Alexandra Spadola, Eric Yuan, Jolanta Kosek, Le Jiang, Eldad Hod, Kerry Li, Vundavalli V Murty, Nicole Schupf, Eric Vilain, Mitzi Morris, Fatemeh Haghighi, Benjamin Tycko
Journal: Nature Genetics (2008)
Suggestion of a dual-functional agent for future trials in nonalcoholic fatty liver disease
Authors: Liang Shen
Journal: Hepatology (2010)

In a recent, interesting article, Musso et al.,1 reviewing reports of randomized controlled trials, comprehensively assessed the efficacy of proposed treatments for nonalcoholic fatty liver disease (NAFLD). The authors concluded that well-designed randomized controlled trials are needed to assess the efficacy of proposed treatments with respect to patient-oriented outcomes contributing to the burden of NAFLD, such as cardiovascular disease (CVD).1 Evidence that has accumulated in recent years supports a potential link between NAFLD and an increased risk of CVD,2, 3 and this has prompted me to add a suggestion to be taken into consideration when future trials are designed to improve treatment efficacy: the employment of a dual-functional agent to combat NAFLD and prevent CVD. For instance, as one of the most important lipid-soluble antioxidants for humans, vitamin E has shown promising results for the treatment of fatty liver diseases, as indicated by many clinical trial studies.4, 5 A recent, rigorous trial that was reported in the New England Journal of Medicine4 found that supplementation with the natural form of vitamin E, in comparison with placebo, was associated with a significantly higher rate of improvement in nonalcoholic steatohepatitis, the most extreme form of NAFLD. Moreover, the beneficial effect of vitamin E on CVD risk is supported by strong epidemiological evidence.6 Therefore, it is rational to infer that vitamin E as a dual-functional agent may be able to treat NAFLD and decrease the risk of CVD, and future trials examining its clinical effects are encouraged. In addition, because oxidative stress plays an important role in both fatty liver disease7, 8 and CVD, the antioxidant activity of vitamin E should be the principal mechanism for treating or preventing these diseases. Because high-dosage vitamin E supplements (≥400 IU/day) potentially increase the risk for all-cause mortality and should be avoided,9 I suggest a moderate dosage of vitamin E in combination with other antioxidants such as vitamin C, which enhances the regeneration of oxidized vitamin E.10 The superiority of vitamin E and vitamin C combination therapy over single supplementation has been reported for several oxidative stress–associated diseases. However, we have to overcome the difficulties brought by the introduction of another intervention in future trials. In summary, because of the increased risk of CVD for patients with NAFLD, the use of a dual-functional agent for the treatment of NAFLD and the prevention of CVD may represent an attractive strategy for improving the treatment efficacy and should be taken into consideration when future trials in NAFLD are being designed. Liang Shen Ph.D.*, * Shandong Provincial Research Center for Bioinformatic Engineering and Techniques, Shandong University of Technology, Zibo, People's Republic of China.
Epitheliomas in patients receiving razoxane therapy for psoriasis
Authors: J.J. HORTON, D.M. MacDONALD, R.S. WELLS
Journal: British Journal of Dermatology (1983)

We report two cases in which cutaneous squamous cell carcinomata developed in patients with psoriasis on razoxane therapy. The relevance of razoxane as well as past treatment for psoriasis in the aetiology of these tumours is discussed.
A151: Pediatric Rheumatology Care and Outcomes Improvement Network Demonstrates Performance Improvement on Juvenile Idiopathic Arthritis Quality Measures
Authors: Julia G. Harris, Esi Morgan DeWitt, Ronald M. Laxer, Stacy P. Ardoin, Beth S. Gottlieb, Judyann C. Olson, Murray H. Passo, Jennifer E. Weiss, Daniel J. Lovell, Tzielan C. Lee, Sheetal S. Vora, Nancy Griffin, Jason A. Stock, Lynn M. Darbie, Catherine A. Bingham
Journal: Arthritis & Rheumatology (2014)

Background/Purpose:

Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) is a multi-site learning network designed to improve outcomes of juvenile idiopathic arthritis (JIA) care. Teams collect point of care data on measures of process of care and outcomes of care for the purposes of analysis to guide improvement activities. Eleven North American pediatric rheumatology centers participate. This report illustrates our improvement in several JIA process quality measures (QMs).



Methods:

Process of care QMs targeted for improvement include measurement of: arthritis-related pain, physician global assessment, joint count, health-related quality of life, physical function, as well as screening for uveitis, medication toxicity, and tuberculosis per guidelines. Outcome measures for JIA include clinical inactive disease, clinical remission on and off medications, no or mild pain level, and optimal physical functioning. Network goals were determined for each process and outcome measure. Data are collected with IRB approval and informed consent, and the shared registry for data entry is the ACR's Rheumatology Clinical Registry. Site-specific and aggregate data are analyzed and displayed monthly via statistical process control charts allowing PR-COIN to track performance over time. Individual centers use established quality improvement methodology to reach and exceed pre-determined goals.



Results:

Data from 5112 encounters for 1134 JIA patients have been collected since April 2011. QMs with performance meeting or exceeding initial goals include documentation of complete joint count and measurement of arthritis-related pain. For PR-COIN network as a collective unit, QMs improved in six processes—measurement of functional ability, completion of ongoing medication toxicity labs, documentation of complete joint count, medication counseling for newly prescribed DMARDs, documentation of annual medication counseling, and measurement of health-related quality of life. All of these measures had a shift above the baseline mean, demonstrating special cause. In addition, five sites have demonstrated individual improvement in at least one process QM.



Conclusion:

PR-COIN sites are collectively and individually demonstrating significant improvements in JIA process of care QMs. Quality improvement efforts in PR-COIN are ongoing with the goal of improving the outcome for patients with JIA.
Pain relief for crushed chests.
Authors: J. N. Lunn, B. R. Kennedy
Journal: BMJ (1968)

MEDICLJOUALthat is, high-speed-sawing, drilling, and sandpapering.The hardwoods would pro- vide greater frictional resistance and conse- quently more breakdown products.The analogy here is with tobacco or with coal.Tobacco is not per se carcinogenic, nor is coal, whereas tobacco smoke and coal tar distillates are.If this alternative suggestion holds true the recommendation by Dr. E.
Leslie Gordon Scott
Authors: Annie Bennett, Issac Suleman, John Surtees
Journal: BMJ (2006)

​FormerFormer consultant paediatrician Eastbourne and Hastings (b 1916; q Guy's Hospital, London, 1939; MD, MRCP, DCH), d 26 March 2006.



Figure 1



Leslie Scott's first junior jobs were at Tunbridge Wells in 1940 treating survivors of Dunkirk and the Battle of Britain. He then joined the Royal Air Force and saw service in North Africa and Italy. In the 1940s Leslie represented junior doctors on a committee chaired by Sir Alexander Fleming to organise the equitable distribution of penicillin. In 1951 he was appointed consultant paediatrician to the Eastbourne and Hastings hospitals, where he remained until his retirement in 1981. He was associated with the Pilgrims' School at Seaford for over 40 years as medical officer and governor. Eastbourne District General Hospital opened a new paediatric unit in his name. Predeceased by his wife, Esme, in 1989, he leaves five children.
A NEW OPERATION FOR HEMORRHOIDS
Authors: Robert A. Bachmann
Journal: JAMA (1913)

This operation resembles the Whitehead inasmuch as in each operation a pile-bearing ring of mucous membrane is removed, but the method employed is so radically different from the Whitehead or any of its modifications that I have preferred not to call it by that name. Eight pairs of curved hemostats and the same number of straight hemostats are required. The rectum is well dilated. Eight deep mattress sutures are placed well beyond the hemorrhoidal mass into sound mucous membrane at points corresponding to 12, 3, 6 and 9 o'clock and half-way between each of these—eight in all. Chromic gut is used. Straight hemostats are attached to ends of sutures left long. Well out on the mucocutaneous junction place corresponding mattress sutures—eight in all—and attach curved hemostats to ends of sutures left long. Hemorrhoids are now between rows of sutures. Cut mucous membrane circularly around the internal row of sutures, avoiding
Soundings: Bad smells are good
Authors: Liam Farrell
Journal: BMJ (2002)

I'm pretty hardy, and not overly sensitive to bad smells; delicacy is not a virtue in this job. Humans can apparently distinguish up to 10 000 different scents, which is useful for docs, as every body fluid has its own distinct aroma, and when these have been percolating for a few weeks or more they can become a heady brew. Smegma, the stuff from infected sebaceous cysts, really stale urine, navel fluff that has been there for a generation, dead bodies, steatorrhoea, purulent phlegm, bad teeth—eight or nine pungent patients during an afternoon surgery on a warm day and the room becomes quite unforgettable.

Not all strong smells are unpleasant. Horse manure (or is it cow dung—can anyone tell the difference?) can be quite invigorating, a good honest reek, like going for a tramp across the fields, a whisper of the countryside to sweeten even the darkest and most bitter surgery.

Smells should indeed be our friends; open your arms and welcome them in. They are such a valuable form of non-verbal communication—for example, “You are only the doctor and not worth getting cleaned up for.” They are also an intrinsic part of the diagnostic process, as with the patient who smelled as if he had been marinated overnight in cat's widdle. “Do you have a cat?” I asked shrewdly, sending off the toxoplasma titre. “How did you know?” he gasped. “Just a wild guess,” I said, nodding sagely, like Sherlock Holmes patronising well meaning but bumbly Dr Watson.

Watson was no role model for me, I preferred Doc Holliday, lean, hungry, doomed, dangerous, decadent, and cynical though he was; he had that touch of fatal glamour, and I bet he smelled of whisky, cigars, and cologne.

Smell is more tenacious than the other senses; get it on your skin and even if you scrub and scrub and scrub you are not washing it off, merely spreading it around, like Lady Macbeth's dread spot. It is more resistant to time. When the catman left the room, though his corporeal body was gone, his presence yet hovered around me like a forlorn and stinky little ghost; the song was over but the memory lingered on, a gift to soften my regret at our parting, also to be savoured by other patients, who probably thought that I was the one with the cat problem. And if some of them did happen to gag, it certainly made them forget the complaint they came in with, which is practically the same thing as a cure, isn't it?
An Uneasy Understanding
Authors: Adrienne E. Shapiro
Journal: Annals of Internal Medicine (2007)

On Being a Doctor4 December 2007An Uneasy UnderstandingAdrienne E. Shapiro, MScAdrienne E. Shapiro, MScFrom Johns Hopkins School of Medicine, Baltimore, MD 21205.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-11-200712040-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail One month into medical school, I arrived in the ultrasound suite to join Dr. Braun for the afternoon. As the preceptor assigned to me for my first year, she would provide me with most of my clinical instruction in the first-year curriculum. Ultrasound was her only clinic time that didn't conflict with my class schedule, so I showed up prepared to learn about nuchal widths and intrauterine growth. Dr. Braun had reassured me that I would spend some time in labor and delivery as well. Still, in the sonogram suite, I fought gamely to hide my dismay that my first ... Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins School of Medicine, Baltimore, MD 21205.Note: All names have been changed.Corresponding Author: Adrienne E. Shapiro, MSc, Johns Hopkins School of Medicine, MSTP Office, Suite 2-300, 1830 East Monument Street, Baltimore, MD 21205; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHumanism at Heart: Preserving Empathy in Third-Year Medical Students 4 December 2007Volume 147, Issue 11Page: 811-812KeywordsBrainForecastingGratitudeHeartLabor and deliveryPregnancySkullSurgeryTechniciansUltrasound imaging ePublished: 4 December 2007 Issue Published: 4 December 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Studies of Left Atrial Pressure During Cardioplegia Produced by Profound Hypothermia Using the Closed Chest Technique
Authors: J. B. Johnston, J. M. Nield, G. R. Pritchard, V. M. Hercus
Journal: Thorax (1965)

Profound hypothermia can be induced and reversed with safety without opening the chest when a heart/lung machine is used (Woodhall, Sealy, Hall, and Floyd, 1960;Patterson and Ray, 1962).Blood is drained into the heart/lung machine from an external iliac vein and, after being oxygenated and cooled or warmed as the case may be, is returned to the body through an external iliac artery (Fig. 1).During cooling, ventricular fibrillation almost always occurs, but this can be reversed externally during rewarming.When the temperature is sufficiently low, it is pos- sible to arrest the circulation completely for long Fio. 1. Diagram of the bypass circuit used in the experiments.periods of time, e.g., at 100 C. a period of 60 minutes of circulatory arrest is well tolerated.When it is possible to arrest the circulation in this way, neurosurgeons have derived considerable benefit when operating on difficult intracranial aneurysms (Patterson and Ray, 1962; Michenfelder, Kirklin, Uihlein, Svien, and MacCarty, 1964).This technique has been used successfully when operating on eight patients in this unit (Gonski, Johnston, Hercus, Rollison, and Nield, 1964).In these operations, when the body is being cooled and rewarmed, there are long periods of cardioplegia.However, blood continues to accu- mulate in the left side of the heart from the bronchial circulation, and it might be anticipated that the left atrial pressure would reach dangerously high levels as the left ventricle can no longer eject its contents.This would lead to irreversible damage in the heart and lungs.In practice, however, the successful clinical results of Patterson and Michenfelder and of the present authors indicate that this cannot be so.The studies described below were designed with the object of finding out what happens to the left atrial pressure under these conditions.METHOD Dogs weighing between 20 and 30 vg. were used.General anaesthesia was induced by injecting intra- venously 4 to 8 ml. of 2% thiopentone followed by 1 mg./kg.suxamethonium chloride.The animal was then intubated under direct vision using the largest possible Magill's tube.Anaesthesia was maintained with oxygen-enriched air with the addition of I to 1% of halothane.The gas mixture was given through a circle absorber, and the animal was placed on con- trolled ventilation using a Beaver Mark 2 respirator.Controlled respiration was continued until the onset 234 on July 10,