tbuckley/cabot-search huggingface dataset:
Evaluating a psychogeriatric domiciliary visit service: views of general practitioners.
Authors: C. Hardy-Thompson, M. W. Orrell, K. Bergmann
Journal: BMJ (1992)

The value of the domiciliary consultation service has recently been questioned1 in view of the increasing cost from 10m pound sterling in 1983 to pound sterling 20m in 1988(23) despite a decrease in the use of the service. General practitioner fund-holding will obviously exert an influence on the future use of domiciliary visits. A recent review of general practitioners' referrals showed how little is understood about the correct level of service.4 Nevertheless, domiciliary consultations are a major component of a modern psychogeriatric service and may be preferred for new referrals. To plan or evaluate services it is vital to know the needs of general practitioners; we therefore investigated general practitioners' views and use of psychogeriatric domiciliary consultations.
Purification, characterization, gene sequence, and significance of a bacterioferritin from Mycobacterium leprae.
Authors: M C Pessolani, D R Smith, B Rivoire, J McCormick, S A Hefta, S T Cole, P J Brennan
Journal: The Journal of Experimental Medicine (1994)

The study of tissue-derived Mycobacterium leprae provides insights to the immunopathology of leprosy and helps identify broad molecular features necessary for mycobacterial parasitism. A major membrane protein (MMP-II) of in vivo-derived M. leprae previously recognized (Hunter, S.W., B. Rivoire, V. Mehra, B.R. Bloom, and P.J. Brennan. 1990. J. Biol. Chem. 265:14065) was purified from extracts of the organism and partial amino acid sequence obtained. This information allowed recognition, within one of the cosmids that encompass the entire M. leprae genome, of a complete gene, bfr, encoding a protein of subunit size 18.2 kD. The amino acid sequence deduced from the major membrane protein II (MMP-II) gene revealed considerable homology to several bacterioferritins. Analysis of the native protein demonstrated the iron content, absorption spectrum, and large native molecular mass (380 kD) of several known bacterioferritins. The ferroxidase-center residues typical of ferritins were conserved in the M. leprae product. Oligonucleotides derived from the amino acid sequence of M. leprae bacterioferritin enabled amplification of much of the MMP-II gene and the detection of homologous sequences in Mycobacterium paratuberculosis, Mycobacterium avium, Mycobacterium tuberculosis, Mycobacterium intracellulare, and Mycobacterium scrofulaceum. The role of this iron-rich protein in the virulence of M. leprae is discussed.
CATARRH OF THE ETHMOID CELLS AND THE FRONTAL SINUS AND THE NASAL CANAL—THE CAUSE, DEPOSIT OF EGGS OF THE SCREW MAGGOT (LARVÆ) AND THEIR DEVELOPMENT.
Authors: FRED. HUMBERT
Journal: JAMA (1883)

Mrs. F. W., a farmer's wife, always enjoyed good health. On Monday, September 27, 1875, about noon, she was attacked with headache, flushed, burning face, and expected a malarial chill. From that time the pain in the region of the frontal bone, at the root of the nose and below the eye, extending to the right ear, increased. At times the pain was more severe than at others, but never entirely left. These pains were described as dropping, tearing and boring, and so excruciating were they that at intervals, day and night, her cries could be heard at a great distance from the house. Tuesday evening bloody mucus began to run from the right nostril, which was some swollen. This swelling extended on Friday over the whole right side of the face. On this day, the fifth of the complaint, four larvae dropped out of the right nostril. When I
Measures of Response: RECIST, WHO, and New Alternatives
Authors: C. Carl Jaffe
Journal: Journal of Clinical Oncology (2006)

RECIST (Response Evaluation Criteria in Solid Tumors) is a widely employed method introduced in 2000 to assess change in tumor size in response to therapy. The simplicity of the technique, however, contrasts sharply with the increasing sophistication of imaging instrumentation. Anatomically based imaging measurement, although supportive of drug development and key to some accelerated drug approvals, is being pressed to improve its methodologic robustness, particularly in the light of more functionally-based imaging that is sensitive to tissue molecular response such as fluorodeoxyglucose positron emission tomography. Nevertheless ready availability of computed tomography and magnetic resonance imaging machines largely assures anatomically based imaging a continuing role in clinical trials for the foreseeable future. Recent advances in image processing enabled by the computational power of modern clinical scanners open a considerable opportunity to characterize tumor response to therapy as a complement to image acquisition. Various alternative quantitative volumetric approaches have been proposed but have yet to gain wide acceptance by clinical and regulatory communities, nor have these more complex techniques shown incontrovertible evidence of greater reproducibility or predictive value of clinical events and outcome. Unless plans are created for clinical trials that incorporate the design needed to prove the added value and unique clinical utility of these novel approaches, any theoretical benefit of these more elaborate methods could remain unfulfilled.
Accuracy of angiographic determination of left main coronary arterial narrowing. Angiographic--histologic correlative analysis in 28 patients.
Authors: J M Isner, J Kishel, K M Kent, J A Ronan, A M Ross, W C Roberts
Journal: Circulation (1981)

To evaluate the accuracy of coronary angiography in identifying severe narrowing of the left main coronary artery (LMCA), the degree of narrowing observed by angiography was compared to that observed at necropsy in 28 patients with symptomatic coronary heart disease in whom angiography had been performed within 40 days of death. The angiograms were evaluated independently by three experienced angiographers. In 20 of the 28 patients (71%), the degree of narrowing of the LMCA was either underestimated (13 patients) or overestimated (10 patients) by two or three of three angiographers; of 84 angiographic judgments made by the three angiographers in the 28 patients, 54 (64%) were underestimates (33 judgments, 39%) or overestimates (21 judgments, 25%) of the degree of LMCA narrowing. Of 12 LMCAs narrowed 76-100% in cross-sectional area at necropsy, six were underestimated at preoperative angiography by two or three of three angiographers; of 12 LMCAs narrowed 51-75% in cross-sectional area at necropsy, all 12 were either under- or overestimated angiographically by two or three of three angiographers; of four LMCAs narrowed 26-50% in cross-section at necropsy, two were overestimated by two of three angiographers. Thus, angiographic determination of degrees of narrowing of the LMCA during life is subject to considerable error. The angiographic errors appear to have resulted primarily from the presence of atherosclerotic plaque in the LMCA and an insufficient number of angiographic projections.
Coxibs and Cardiovascular Disease
Authors: Garret A. FitzGerald
Journal: New England Journal of Medicine (2004)

The coxibs are a subclass of nonsteroidal antiinflammatory drugs (NSAIDs) designed to inhibit selectively cyclooxygenase-2 (COX-2).1 Their development was based on the hypothesis that COX-2 was the source of prostaglandins E2 and I2, which mediate inflammation, and that cyclooxygenase-1 (COX-1) was the source of the same prostaglandins in gastric epithelium, where they afford cytoprotection. Three coxibs — celecoxib, rofecoxib, and valdecoxib — have been approved for use by the Food and Drug Administration (FDA); a fourth, etoricoxib, has been approved by the European regulatory authority, and it and a fifth, lumiracoxib, are currently under consideration for FDA . . .
Sympathetic Control of Coronary Circulation
Authors: ERIC O. FEIGL
Journal: Circulation Research (1967)

The sympathetic control of left circumflex coronary blood flow was studied by stellate ganglion and hypothalamic stimulation. Flow was measured acutely in dogs under chloralose or pentobarbital anesthesia by an electromagnetic flowmeter. Coronary vasoconstriction was observed when the left stellate ganglion was stimulated after blocking beta receptors with propranolol or INPEA. The possibility of coronary sympathetic cholinergic vasodilation of the type found in skeletal muscle was examined in three types of experiments in which vasodilation occurred in skeletal muscle: (1) peripheral sympathetic nerve stimulation after chronic catecholamine depletion with reserpine, (2) peripheral sympathetic nerve stimulation after acute block of alpha and beta receptors, (3) hypothalamic stimulation to give a defense reaction after acute block of alpha and beta receptors. Within the limits of these experiments, skeletal muscle cholinergic vasodilation was demonstrated but coronary sympathetic cholinergic vasodilation was not, even as part of the defense reaction elicited by hypothalamic stimulation.
Influence of a Child's Sex on Medulloblastoma Outcome
Authors: Michael D. Weil
Journal: JAMA (1998)

Context.—Aggressive treatment of medulloblastoma, the most common pediatric brain tumor, has not improved survival. Identifying better prognostic indicators may warrant less morbid therapy.Objective.—To investigate the role of sex on outcome of medulloblastoma.Design.—Retrospective study of significant factors for survival with a median follow-up of 82 months.Setting.—University medical center.Patients.—A total of 109 consecutive, pediatric patients treated for primary medulloblastoma from 1970 to 1995 with surgery and postoperative radiotherapy and, after 1979, chemotherapy.Main Outcome Measures.—Factors independently associated with survival.Results.—The final multivariate model predicting improved survival included sex (hazard ratio, 0.52; 95% confidence interval [CI], 0.29-0.92; P=.03; favoring female), metastases at presentation (hazard ratio, 2.01; 95% CI, 1.14-3.52; P=.02), and extent of surgical resection (hazard ratio, 0.60; 95% CI, 0.34-1.04; P=.07; favoring greater resection). The overall, 5-year freedom from progression was 40% and survival was 49%. Radiotherapy dose (P=.72), and chemotherapy (P=.90) did not significantly affect a disease outcome.Conclusions.—The sex of the child was an important predictor for survival of medulloblastoma; girls had a much better outcome. The difference in survival between sexes should be evaluated in prospective, clinical trials.
Medical Peer Review of Physician Competence and Performance: Legal Immunity and the Antitrust Laws
Authors: William J. Curran
Journal: New England Journal of Medicine (1987)

IN the midst of another medical malpractice crisis, medical peer-review programs concerning the quality of physicians' performance are receiving renewed attention as at least partial solutions to the problem. State legislatures are mandating comprehensive programs of peer review in all licensed hospitals, health maintenance organizations, and other health care programs. Despite these enactments, however, the effectiveness of peer-review performance monitoring has been greatly undermined by a genuine fear of retaliatory lawsuits brought by physicians who are the subjects of disciplinary action. Some states have passed "shield laws" that are designed to provide a degree of legal immunity for hospital peer-review . . .
Doctors' Remuneration — Hospital Politics — Great Characters
Authors: John Lister
Journal: New England Journal of Medicine (1956)

THE question of the remuneration of the medical profession in the National Health Service was a matter of protracted negotiation at the start of the Service. The terms offered by the Government were based on the recommendations of the Spens Committee, which estimated the total remuneration that the profession could reasonably expect in the light of the previous earnings of general practitioners and consultants. The figures quoted by the Spens Committee were in terms of the 1939 value of money, and since the inception of the Service the only adjustments that have been made have been to bring these figures . . .
Cholecystectomy and Abdominal Hysterectomy
Authors: Victor A. Silberman
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The article "Cholecystectomy and Abdominal Hysterectomy" by Murray et al (1980;244:2305) raises several interesting points of discussion. The fact that the series of 21 cases described by Murray et al and a report by Pratt et al in 1967 of 95 similar combined procedures are the only two such reports in the literature, to my knowledge, suggests that not too many surgeons and gynecologists agree with the wisdom of such an operation. Speaking as a surgeon, my chief objection to this approach is the potential tendency to eliminate an operative cholangiogram or common duct exploration because of the additional time required in an already lengthy operation. Under the usual circumstances of a single procedure, there would be no hesitation in carrying out these important steps when indicated. Time would eventually tell how many common bile duct stones were overlooked. Prophylactic cholecystectomy in asymptomatic patients is justified when
Modulation of the effector function of human monocytes for Mycobacterium avium by human immunodeficiency virus-1 envelope glycoprotein gp120.
Authors: H Shiratsuchi, J L Johnson, Z Toossi, J J Ellner
Journal: Journal of Clinical Investigation (1994)

Disseminated Mycobacterium avium infection in AIDS is associated with high tissue burdens (10(9)-10(10) mycobacteria/g tissue) of organism. The basis for the extraordinary susceptibility of AIDS to M. avium infection is unclear. HIV or its constituents may alter mononuclear phagocyte functions resulting in enhanced intracellular M. avium growth. The effects of an envelope glycoprotein (gp120), a transmembrane protein (p121), and core proteins of HIV-1 on M. avium infection of human monocytes were examined. Preculturing monocytes with gp120 inhibited M. avium phagocytosis and consistently enhanced intracellular growth of six M. avium strains. Pretreatment with p121, gag5, or p24 did not inhibit phagocytosis nor enhance intracellular growth of M. avium. Incubation of gp120 with soluble CD4 before addition to monocyte cultures or pretreatment of monocytes with OKT4A abrogated gp120 effects on M. avium phagocytosis and intracellular growth. gp120 also augmented cytokine production by infected monocytes. These results suggest that gp120, but not p121 or core proteins, modulate monocyte phagocytosis and enhance intracellular growth of M. avium at least in part through monocyte CD4 receptors. Direct effects of HIV-1 products may, therefore, contribute to the diathesis of AIDS to develop disseminated M. avium infection and to the extensive replication of the organisms within tissue macrophages.
Emerging approaches in preventing cardiovascular disease
Authors: Eva M Lonn, Salim Yusuf
Journal: BMJ (1999)

This is the first of four articles

Reducing cholesterol and blood pressure, as well as smoking cessation, have been shown to be effective strategies for preventing cardiovascular diseases.1 However, these “classical” risk factors, along with known non-modifiable risk factors such as age, sex, and family history, cannot fully explain why some people develop myocardial infarction and stroke, while others do not.2–4 Additional factors may have a role in the pathogenesis of atherosclerosis, and new preventive strategies may be of use. In this article we briefly review the use of antioxidants, the use of angiotensin converting enzyme inhibitors, and homocysteine lowering; other “emerging” cardiovascular risk factors and potential preventive strategies that are under investigation are summarised in table 1.

### Summary points

Classical risk factors for atherosclerosis cannot fully explain why certain people develop coronary heart disease and stroke, while others do not

Other potential (“emerging”) risk factors for atherosclerosis and new preventive therapies are currently being studied

Promising new preventive therapies include antioxidants, lowering of homocysteine concentrations, decreasing the activation of the renin-angiotensin and the coagulation systems, antibiotics, and anti-inflammatory agents

These therapies have not been proved in clinical trials; at present, the emphasis should be on treating established risk factors and consistently applying therapies that are known to reduce cardiovascular morbidity and mortality

Extensive laboratory data show that oxidative modification of low density lipoprotein cholesterol is an important step in the pathogenesis of atherosclerosis, and experimental studies in different animal models show that antioxidants decrease oxidation of low density lipoprotein cholesterol and reduce plaque formation. 5 6

Epidemiological studies have generally reported that increased intake of antioxidants through diet or supplements, particularly vitamins E and C and β carotene, is associated with a lower risk of coronary heart disease.7–9 Other antioxidants, such as other …
Inositol Supplementation in Premature Infants with Respiratory Distress Syndrome
Authors: Mikko Hallman, Kristina Bry, Kalle Hoppu, Marjatta Lappi, Maija Pohjavuori
Journal: New England Journal of Medicine (1992)

Inositol influences cellular function and organ maturation. Feeding premature infants inositol-rich breast milk increases their serum inositol concentrations. Whether inositol supplementation benefits infants receiving fluids for parenteral nutrition, which are inositol-free, is not known.
The influence of infection early after allogeneic stem cell transplantation on the risk of leukemic relapse and graft‐versus‐host disease
Authors: Sung‐Yong Kim, Dong‐Gun Lee, Myung‐Shin Kim, Hee‐Je Kim, Seok Lee, Chang‐Ki Min
Journal: American Journal of Hematology (2008)

An infection after allogeneic stem cell transplantation (SCT) can affect the activity of immune cells and increase the level of proinflammatory cytokines. Further, a post-SCT infection may influence the milieu of the graft-versus-leukemia (GVL) effect and graft-versus-host disease (GVHD). We performed a retrospective study of patients with acute leukemia who had undergone allogeneic SCT using the same preparative regimens and bone marrow as the stem cell source to determine if early post-transplant infection was associated with the risk of leukemic relapse and GVHD. The analysis revealed that patients who had a febrile infection (FI) before post-transplant day 21 (FI group) had a lower actuarial probability of leukemic relapse (P < 0.001) and a higher relapse-free survival rate (P = 0.012) than those patients who did not have a FI before post-transplant day 21 (non-FI group). The experience of early post-transplant FI (HR = 0.316; 95% CI = 0.174-0.575; P < 0.001), together with the presence of chronic GVHD and high risk cytogenetics, were independent predictive factors for post-transplant leukemic relapse. The FI group had a trend towards a higher lymphocyte count on post-transplant day 21 than the non-FI group (P = 0.063), despite the delayed recovery of the platelet count and a trend towards delayed recovery of the neutrophil count. These findings suggest that a change in the immunologic network by infectious diseases in the early post-transplant period favors the milieu of the GVL effect. The specific immunologic change during FI, which can potentiate the GVL effect, remains to be determined.
A NOTE ON CERTAIN OF THE VASCULAR PHENOMENA OF CARDIAC DISEASE
Authors: B. Parsons-Smith
Journal: BMJ (1916)

MEDICAL Jou3uaLIprinciple of the brace should be adopted.The idea was tlhat the old form of accoutrement restricted the heart's action.The committee described the condition of irritable lheart, which it seems to have recognized clearly as "an extremue excitability of the heart, combined with some, but not great, enlargement.During rest a heart of this kind beats easily, but on the least exertion its action becomes irregular, and the man becomes breathless."The recommendation of the committee regarding the change of accoutrement was later on adopted.Tlle American Civil War meanwhile was furnishing a large number of cases of " soldier's heart," and in 1864 Henry Harthorne published a paper in the American Journal of Medical Science which, I venture to say, furnislhes an exact picture of the condition as Sir James Mackenzie has described it to-day.Dr. Harthorne laid stress on the rapidity of the pulse, on the acceleration of the hleart's movements on the sliglhtest exertion, on the shortness of breath, and on the cardiac muscular weak- ness.He suggested that in the soldier the heart was injuriously affected by long-continued over-exertion with deficiency of rest and often of nourishment, and he pointed out that several months of rest and treatment in hospital failed to do more than improve without really curing a large proportion of well-marked cases.Two causes lhad thus been suggested so far back as 1864 -tighlt accoutrements and over-exertion.The tight accoutrements were done away with, but the irritable heart remained.I pass over here the contribution to the subject made by Dr. Arthur Myers, of the Coldstream Guards, in 1870, because his description is similar to that already given, and because he also regarded accoutrements as the exciting cause of the trouble.But I must call attention specially to the paper of Da Costa published in 1871 in the American Journal of Medical Sience.It is the best linown contribution to the subject.Da Costa saw upwards of 300 cases in a hospital in Philadelphia, and lhe affords the following striking picture:A man, three months or so on active service, was seized with diarrhoea, annoying yet not severe, soon rejoined, and then noticed that lhe could not bear exertion as well as formerly.Out of breath and uinable to keep up with his comrades; dizzi- iness and palpitation; accoutrements oppressed him, yet other- wise hle seemed well and healthy.Sought advice; was sent to hospital, where his persistent quick heart confirmed his story.Digestive disturbances, if present, passed away, but the irritable conditioll of the heart remained, and only very slowly did this get normal or it failed to do so.
Tow Cases of Cow's-milk Allergy
Authors: B. D. Bower, D. G. Stanley-Roose, O. H. Wolff
Journal: BMJ (1958)

Acute allergic reactions to cow's milk in infancy are un- common enough to justify a description of two cases that presented problems in diagnosis and management.In particular, the occurrence of ascites in one case deserves mention as a sign not previously reported. Case 1The patient, a female infant, was.delivered by caesarean section after a 38-weeks' pregnancy.She was the first child of healthy parents and there was no family history of allergy.The neonatal period was uneventful.She was, fully breast-fed until 3 weeks of age, when she was given a bottle feed of dried milk (" ostermilk No.I ").Immediately after this feed she vomited, and the next day developed diarrhoea with much mucus but no blood in the stools.Rapid deterioration with fever, intense irritability, and fur- ther vomiting led to her admission to the Children's Hos- pital, Birmingham, on July 26, 1956, within 48 hours of the first feed of cow's milk.On admission she was shocked with peripheral cyanosis, a fever of 1030 F. (39.4'C.), pulse rate of 160. and respira- tion rate of 50.Her cry suggested pain.The abdomen was distended and tympanitic, but no other signs were found.