tbuckley/cabot-search huggingface dataset:
Health Centre X-ray Unit
Authors: J. H. Barber, E. T. Robinson, S. Morey, S. Hasse
Journal: BMJ (1974)

An analysis of the types and numbers of x-ray films requested in the first year of a health centre x-ray unit showed that chest films represented the largest proportion of these. The unit is most valuable when it is inmediately available to the patient and general practitioner at the time of consultation, and thus it should be open for at least five sessions per week. The likely referral rate for the health centre x-ray unit is 84 patients per 1,000 at risk, and a unit functioning for five sessions a week can examine 60 patients during that time. This minimum of five sessions would be fully used by a population of 30,000 patients. The running costs were found to be about the same as those of a hospital x-ray unit.
The Excess Mortality of Black Adults in the United States
Authors: Harvey A. Schwartz
Journal: JAMA (1990)

<h3>To the Editor.—</h3> I read with great interest the article by Otten et al<sup>1</sup>on the effect of risk factors on the excess mortality of black adults. I was encouraged by the point made that family income and risk factors were interdependent and by the closing statement, "While programs are developed to target the remediable excess mortality, investigations will need to continue to identify intervenable factors associated with income and to study social and health system factors not included in this study." I was, however, disappointed by the income measures used, for two reasons: first, the family income data used were outdated, and second, they probably differentially represent the economic well-being of blacks and whites during the period of study (1971 to 1984). The family income information used in the study represents estimates of family income of respondents from the First National Health and Nutrition Examination Survey (NHANES
Metastasis to the Spinal Cord
Authors: L. G. Walker
Journal: JAMA (1968)

<h3>To the Editor:—</h3> In "The Treatment of Metastatic Spinal Cord Tumors," (<b>202</b>:686, 1967), the authors stated that they found only three cases reported in the literature of intramedullary metastasis to the spinal cord. Of these, one each was from the breast, lung, and a lymphosarcoma. There have, however, been at least 33 cases of intramedullary spinal cord metastasis reported. Benson<sup>1</sup>reviewed the literature in 1960 and found 27 cases of which 13 were from primary carcinoma of the lung. Lombardo and Saenz Arroyo added three cases in 1962.<sup>2</sup>Greenberg and associates<sup>3</sup>in 1965 found a total of 31 cases in the literature to which they added a bronchogenic carcinoma with intramedullary metastasis at the conus. We<sup>4</sup>added a case report of intramedullary spinal cord metastasis from carcinoma of the colon in 1967, the second case reported from a colon carcinoma. Although they are certainly rare,
Role of Technetium-99m N,N-Ethylenedicysteine Renal Scintigraphy in the Evaluation of Differential Renal Function and Cortical Defects
Authors: Gulgun Buyukdereli, Isa Burak Guney
Journal: Clinical Nuclear Medicine (2006)

This study was performed to evaluate the effectiveness of technetium-99m N,N-ethylenedicysteine (Tc-99m EC) in comparison to technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) scintigraphy. Differential renal function (DRF) was calculated by both methods and the cortical-phase images of dynamic Tc-99m EC scintigraphy were evaluated for parenchymal defects.A total of 62 patients with various kidney disorders ranging in age from 1 to 44 years underwent both Tc-99m DMSA and Tc-99m EC scintigraphy. Tc-99m EC summed images of the cortical phase and Tc-99m DMSA images were evaluated visually and quantitatively. Visual analysis was used to define renal parenchymal abnormalities. Quantitative analysis was used in the calculation of DRF. The Tc-99m DMSA scan was taken as the gold standard, and the summed Tc-99m EC scan findings were compared against it.The images obtained with Tc-99m DMSA and Tc-99m EC scintigraphy revealed 99 and 97 focal defects, respectively. The 2 renal parenchyma defects located in the ventral middle sections remained undetected with Tc-99m EC scintigraphy. DRF of the kidneys in each patient was compared using both radiopharmaceuticals. Highly positive correlation between the differential function of these 2 investigations was found (R = 0.91, P = 0.001). The values of mean DRF of the left kidney on Tc-99m EC and Tc-99m DMSA images were 45.8 +/- 19.1 and 45.0 +/- 20.4, respectively. There were no significant differences (P > 0.05).This study suggests that although Tc-99m DMSA scintigraphy remains the gold standard method for evaluating parenchymal abnormalities, Tc-99m EC scintigraphy can be a reliable single-modality study to evaluate renal cortical defects, DRF, perfusion, drainage of the urinary system, and indirect evidence of vesicoureteric reflux with the added advantage of low radiation exposure to the patient.
Errors in deciding fetal sex from ultrasonography can lead to domestic abuse
Authors: Roger Dobson
Journal: BMJ (2007)

Incorrect determination of the sex of a fetus from ultrasonography can result in marital conflict, domestic abuse, and economic hardship, says a study carried out in Nigeria, where male offspring are highly desirable.

The psychological and physical health of the mother and the upbringing of the child can be affected by such misinformation, says the report ( International Journal of Gynecology and Obstetrics : doi: 10.1016/j.ijgo.2007.09.021).

“The failure rate of ultrasound scans to determine foetal sex should be made known to women and their partners,” the authors write.

The authors, who cite other studies indicating that the accuracy of …
MicroRNA regulation of messenger-like noncoding RNAs: a network of mutual microRNA control
Authors: Yi Zhao, Shunmin He, Changning Liu, Songwei Ru, Haitao Zhao, Zhen Yang, Pengcheng Yang, Xiongyin Yuan, Shiwei Sun, Dongbo Bu, Jiefu Huang, Geir Skogerbø, Runsheng Chen
Journal: Trends in Genetics (2008)
Transjugular intrahepatic portosystemic shunt for treatment of portal hypertension due to extramedullary hematopoiesis in idiopathic myelofibrosis
Authors: Bernhard Angermayr, Manfred Cejna, Maria Schoder, Fritz Wrba, Peter Valent, Alfred Gangl, Markus Peck-Radosavljevic
Journal: Blood (2002)
Use of Medical Service-Reply
Authors: Emmett B. Keeler
Journal: JAMA (1984)

In Reply.—  The Health Insurance Experiment showed that people with free medical care use more services. Dr Jonas implies that the increase is temporary and is caused by such people catching up with previously unmet needs. Several results make this unlikely. First, the response to cost sharing was about the same across the three years we have studied. Second, a week-by-week analysis of use shows that people with free care had initial surges only in well and dental care. These surges lasted only 12 weeks and together represented an additional 0.3 episodes per person. 1 The tremendous increases in dentures and spectacles supplied in the early years of the British National Health Service were not seen, presumably because there was much less unmet need in the United States in 1976 than in Britain in 1948. Third, chronic and well care episodes (where unmet needs might be expected) were rarer and
"Compulsive plague! pain without end!" How Richard Wagner played out his migraine in the opera Siegfried
Authors: C. H. Gobel, A. Gobel, H. Gobel
Journal: BMJ (2013)

<h3>Background:</h3> Earlier publications have suggested a possible role for the efflux transporter breast cancer resistance protein (BCRP) in acquired resistance to disease-modifying antirheumatic drugs (DMARDs) such as leflunomide and its metabolite A771726 (teriflunomide). However, there is no direct evidence that BCRP interacts with these drugs. <h3>Objectives:</h3> To characterise the interaction between BCRP transporter and leflunomide and its active metabolite A771726, with emphasis on the nature of the interaction (substrate or inhibitor) and the kinetic characterisation of the interactions. <h3>Methods:</h3> Different in vitro membrane-based methods (ATPase and vesicular transport assay) using BCRP-HAM-Sf9 membrane preparations and cellular assays (Hoechst assay and cytotoxicity assay) were performed on PLB985-BCRP and HEK293-BCRP cell lines overexpressing BCRP. <h3>Results:</h3> In all assays used, an interaction between the investigated drugs and BCRP was detected. In the vesicular transport assay, both leflunomide and its metabolite inhibited BCRP-mediated methotrexate transport. Both compounds are likely substrates of BCRP as shown by the vanadate-sensitive ATPase assay. In line with the membrane assays, leflunomide and A771726 inhibited BCRP-mediated Hoechst efflux from PLB985-BCRP cells. In the cytotoxicity assay, overexpression of BCRP conferred 20.6-fold and 7.5-fold resistance to HEK293 cells against leflunomide and A771726, respectively. The resistance could be reversed by Ko134, a specific inhibitor of BCRP. <h3>Conclusion:</h3> Based on these results, BCRP could play an important role in the resistance to leflunomide and A771726 via interactions with these drugs. BCRP may also mediate drug-drug interactions when leflunomide is administered with other BCRP substrate drugs such as methotrexate.
"THE UNDERTAKER AND POSTMORTEM EXAMINATIONS"
Authors: D. S. Lamb
Journal: JAMA (1924)

<h3>To the Editor:</h3> —Apropos of the editorial on this subject (The Journal, November 8, p. 1514), you may be interested to know that during my fifty-four years' service at the Army Medical Museum, Washington, I made some 1,500 postmortem examinations, but, although the list included persons in public life, lawyers, physicians, pharmacists, army and navy officers, nearly all ages, both sexes, I never made such examination on an undertaker or member of his family. But I must say that some undertakers are very helpful in the work.
A simple method for studying chemotaxis, vascular permeability and histological modifications induced by mediators of inflammation in vivo in man
Authors: L. MICHEL, L. DUBERTRET
Journal: British Journal of Dermatology (1985)

A new method is described allowing the quantitative and kinetic analysis, in vivo in human skin, of the chemotaxis of inflammatory cells, of the modifications of vascular permeability and of the histological and cytological events induced by certain mediators of inflammation. In order to illustrate the usefulness of the method, the effects of chronic contact to human skin of two potent mediators of inflammation, LTB4 and Paf-acether, are described.
(16) Ichthyosiform erythroderma
Authors: S.W. Lanigan, J.A. Cotterill
Journal: British Journal of Dermatology (1987)

Journal Article (16) Ichthyosiform erythroderma Get access S.W. Lanigan, S.W. Lanigan The General Infirmary at Leeds Search for other works by this author on: Oxford Academic Google Scholar J.A. Cotterill J.A. Cotterill The General Infirmary at Leeds Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 117, Issue s32, 1 June 1987, Pages 64–65, https://doi.org/10.1111/j.1365-2133.1987.tb12057.x Published: 01 June 1987
Assessment of abnormal blood flow and efficacy of treatment in patients with systemic sclerosis using a newly developed microwireless laser Doppler flowmeter and arm-raising test
Authors: M. Kido, S. Takeuchi, S. Hayashida, K. Urabe, R. Sawada, M. Furue
Journal: British Journal of Dermatology (2007)

Background Patients with systemic sclerosis (SSc) frequently suffer from recalcitrant digital ulceration because of impaired cutaneous blood flow (CBF). A simple and accurate CBF measurement would be helpful to evaluate the disease status and efficacy of treatment in such patients. Objectives To examine the feasibility of a newly developed, micromachined integrated laser blood flowmeter (MILBF) for evaluation of abnormal CBF responses in patients with SSc. Methods CBF of finger pulp was measured in eight patients with SSc and in six healthy controls using MILBF. CBF in the steady state and the responses to the arm-raising test and cold provocation were assessed. The therapeutic efficacy of a single and an intensive prostaglandin E(1) (PGE(1)) infusion treatment was also evaluated in some of the SSc patients. Results The patients with SSc showed significantly lower steady-state CBF than controls. The rate of blood flow with cold provocation and the velocity of blood flow recovery after cold provocation (VR-CP) tended to be lower in patients with SSc. Augmentation of amplitude of the digital pulse wave by arm raising (AA-AR) was observed in controls, but not in patients with SSc. We also found that VR-CP and AA-AR may be good markers for evaluating the efficacy of vasodilatory treatment. It should be noted that the examined patients did not complain of any pain and/or distress during the arm-raising test, as opposed to during cold provocation. Conclusions CBF assessment using MILBF and an arm-raising test is accurate, noninvasive and well tolerated and thus the combination may be a better alternative method to evaluate abnormal CBF and efficacy of treatment in patients with SSc.
What Do You Do When Your Loved One Is Ill? The Line between Physician and Family Member
Authors: Erik K. Fromme, Neil J. Farber, Stewart F. Babbott, Mary E. Pickett, Brent W. Beasley
Journal: Annals of Internal Medicine (2008)

Conventional wisdom and professional ethics generally dictate that physicians should avoid doctoring family members because of potential conflicts of interest. Nevertheless, cross-sectional surveys find that the practice is commonplace. Physicians have unique opportunities to influence their family member's care because they possess knowledge and status within the health care system; however, when physicians participate in the care of family members, they must not lose objectivity and confuse their personal and professional roles. Because health care systems are complicated, medical information is difficult to understand, and medical errors are common, it can be a great relief for families to have someone "on the inside" who is accessible and trustworthy. Yet, the benefits of becoming involved in a loved one's care are accompanied by risks, especially when a physician takes action that a nonphysician would be incapable of performing. Except for convenience, most if not all of the benefits of getting involved can be realized by physician–family members acting as a family member or an advocate rather than as a physician. Rules about what is or what is not appropriate for physician–family members are important but insufficient to guide physicians in every circumstance. Physician–family members can ask themselves, "What could I do in this situation if I did not have a medical degree?" and consider avoiding acts that require a medical license.
Effect of cell density and epidermal growth factor on the inducible expression of CYP3A and CYP1A genes in human hepatocytes in primary culture
Authors: J Greuet, L Pichard, J C Ourlin, C Bonfils, J Domergue, P Le Treut, P Maurel
Journal: Hepatology (1997)

The influence of cell density and epidermal growth factor (EGF) on the expression and inducibility of cytochrome P450 (CYP) genes of the CYP3A and CYP1A families in adult human hepatocytes in primary culture has been evaluated. Only when cultured at subconfluence and in the presence of EGF did hepatocytes exhibit a proliferative response, assessed by measuring DNA synthesis and cyclin A accumulation. In the absence of EGF, the accumulation of CYP3A4 and CYP1A2 messenger RNAs (mRNAs) in response to their respective inducers (rifampicin and dioxin) was dramatically decreased in subconfluent culture with respect to confluent cultures. The presence of EGF only slightly decreased the accumulation of these mRNAs in both confluent and subconfluent cultures. The accumulation of CYP2D6 and CYP2E1 proteins, which are constitutively expressed in confluent cultures, and the production of fibrinogen and apolipoprotein (Apo) B100 exhibited similar behavior, while nicotinamide adenine dinucleotide phosphate cytochrome c reductase activity was affected neither by cell density nor by EGF. In contrast, the accumulation of CYP1A1 mRNA in response to dioxin was similar in confluent and subconfluent cultures, irrespective of the presence of EGF. Interestingly, CYP3A7, a gene that is preferentially expressed in the fetal liver, was expressed constitutively neither in confluent nor in subconfluent cultures, irrespective of the presence of EGF. It is concluded that the loss of cell-cell contacts rather than the proliferative status of cells per se is responsible for the dramatic decrease in the expression of CYP genes, normally expressed in the adult human liver.
Hospital formularies restrict evidence based practice
Authors: Joseph Kwan
Journal: BMJ (2005)

Junior doctors' shifts and sleep deprivation New on-call rotas do not workEditor-Clearly the editorial by Murray et al on junior doctors' shifts has struck a chord with many, as on-call rotas are something close to many doctors hearts. 1 2 To most it seems the grass is not greener on the other side.Having worked most rotas, be it a traditional one in four, with full weekends, to partial, hybrid, and full shift patterns, I am in a reasonable position to comment on what I think makes a liveable on-call rota.I was under the impression that the European Working Time Directive was set out to improve the health and safety of workers, make working conditions better, but also make life away from work better because doctors would be less tired.The directive scores a "no" against all of these.I find myself more tired at work and at home, less enthusiastic, and less motivated by what is becoming a regular chore.Instead of being on call once a week, I find myself doing an on-call shift two or three times a week (on average), being late home more often than not because fewer juniors are around, and spending less time with my young children.The "old" rota system of a 24 hour oncall, with at least six on a rota, made on-call shifts less frequent, more tolerable, and even enjoyable.It also left plenty of time for training, and so long as there were six or more on rota, it made the annual leave far more flexible and workable.Anaesthetists rarely complained, certainly compared with other specialties' rotas, and everyone knew that however busy, you were always going to go home to a full day off in the morning.Why not listen to those doing the rota, and affected family members, and respect within reason what the workers want to work.
370 HBV REACTIVATION FOLLOWING CHEMOTHERAPY IN HBSAG NEGATIVE / HBCAB POSITIVE PATIENTS IS ASSOCIATED WITH NON-A GENOTYPE AND THE EMERGENCE OF HBSAG MUTANTS
Authors: P. Borentain, P. Colson, D. Coso, A. Motte, E. Bories, C. Chabanon, C. Tamalet, R. Gerolami
Journal: Journal of Hepatology (2011)
STUDIES IN HUMAN IMMUNIZATION AGAINST INFLUENZA
Authors: G. K. Hirst, E. R. Rickard, W. F. Friedewald
Journal: The Journal of Experimental Medicine (1944)

The administration to human beings of formalin-killed influenza virus, concentrated from allantoic fluid, resulted in a high order of antibody response within 2 weeks after injection. Even after 1 year the great majority of individuals vaccinated had antibody levels considerably above their prevaccination titer for the PR8, Lee, and a current 1943 strain. An investigation of the occurrence of epidemic influenza A in seven widely separated populations, 1 year after vaccination of part of these groups, showed that the attack rate among vaccinated persons was consistently lower than that of control individuals. The average reduction in attack rate was of the order of 35 per cent.
Angiographically silent atherosclerosis detected by intravascular ultrasound in patients with familial hypercholesterolemia and familial combined hyperlipidemia: Correlation with high density lipoproteins
Authors: Dirk Hausmann, Jay A. Johnson, Krishnankutty Sudhir, William L. Mullen, Guy Friedrich, Peter J. Fitzgerald, Tony M. Chou, Thomas A. Ports, John P. Kane, Mary J. Malloy, Paul G. Yock
Journal: Journal of the American College of Cardiology (1996)

Objectives. This study sought to evaluate the extent of atherosclerosis in coronary and iliac arteries in patients with heterozygous familial hypercholesterolemia or familial combined hyperlipidemia, using intravascular ultraound imaging. Background. Intravascular ultrasound imaging provides cross-sectional tomographic views of the vessel wall and allows quantitative assessment of atherosclerosis. Methods. Forty-eight nonsmoking, asymptomatic patients with heterozygous familial hypercholesterolemia or familial combined hyperlipidemia underwent intravascular ultrasound imaging of the left anterior descending coronary, left main coronary and common iliac arteries. Angiography showed only minimal or no narrowing in these vessels. Intravascular ultrasound images obtained during catheter pullback underwent morphometric analysis. Plaque burden was expressed as the mean and maximal intimal index (ratio of plaque area and area within the internal elastic lamina) and as the percent of vessel surface covered by plaque. Results. Intravascular ultrasound detected plaque more frequently than angiography in the left anterior descending (80% vs. 29%, respectively), left main (44% vs. 16%) and iliac arteries (33% vs. 27%). Plaque burden was higher in the left anterior descending (mean intimal index [±SD] 0.25 ± 0.16) than in the left main (0.11 ± 0.16, p < 0.001) and iliac arteries (0.02 ± 0.04, p < 0.001). Angiography detected lumen narrowing only in coronary arteries with a maximal intimal index ⪰0.42 (left anterior descending artery) and ⪰0.43 (left main artery). The area within the internal elastic lamina increased with plaque area in the left anterior descending (r = 0.82, p < 0.001) and left main arteries (r = 0.53, p < 0.001). By stepwise multiple regression analysis, the strongest predictor for plaque burden in the left anterior descending artery was the level of high density lipoprotein (HDL) cholesterol and total/HDL cholesterol ratio for the left main artery. Conclusions. In patients with heterozygous familial hypercholesterolemia and familial combined hyperlipidemia, extensive coronary plaque is present despite minimal or no angiographic changes. Compensatory vessel enlargement and diffuse involvement with eccentric plaque may account for the lack of angiographic changes. Levels of HDL cholesterol and total/HDL cholesterol ratio are far more powerful predictors of coronary plaque burden than are low density lipoprotein cholesterol levels in these patients with early, asymptomatic disease.
Maternal-Fetal Transmission of HIV-1
Authors: Soumitra Sarkar
Journal: JAMA (1995)

To the Editor.  —I read with interest the article by Dr Boyer and colleagues. 1 I have a few comments regarding the analysis in this otherwise excellent study. The authors considered 68 live-born infants, including two sets of twins, from 66 pregnancies in 63 women as 68 independent mother-infant pairs in the analysis. As multiple pregnancies in one woman as well as a set of twins are not independent, this assumption is erroneous.  The data presented in Table 2 of their article should have been stratified by zidovudine treatment. For determining the effect of zidovudine in preventing transmission, multiple regression analysis controlling for confounders (maternal CD4 cell count, viral titer, duration of human immunodeficiency virus [HIV] infection, acquired immunodeficiency syndrome— defining illnesses for in utero transmission and maternal blood exposure, and genital lesions for intrapartum transmission) should have been used.
Reply to “ESR1 gene amplification in breast cancer: a common phenomenon?”
Authors: Frederik Holst, Phillip Stahl, Olaf Hellwinkel, Ana-Maria Dancau, Antje Krohn, Laura Wuth, Christian Heupel, Annette Lebeau, Luigi Terracciano, Khawla Al-Kuraya, Fritz Jänicke, Guido Sauter, Ronald Simon
Journal: Nature Genetics (2008)