tbuckley/cabot-search huggingface dataset:
AN IMPROVED UTERINE CLAMP AND RETRACTOR
Authors: A. MILES TAYLOR
Journal: JAMA (1910)

The clamp illustrated is one which I have devised, believing that it will serve the purpose for which it is intended better than any clamp heretofore available. I find it very useful in all eases in which it is desired to elevate and hold up the uterus. Being devoid of teeth it does not injure or macerate the parts. The curves of the instrument allow it to fit around the uterus and it is not in the way in operating on the uterus or append-ages from any side. In some cases it may be used as a retractor. The jaws of the instrument are bent so as to grasp and surround the neck of the uterus without in any way injuring it. The jaws being on a swivel are not apt to produce sufficient pressure to do damage.  I have used the instrument in abdominal hysterectomies, removal of the appendages, in operations for ovarian lesions, shortening of the
Opposition MPs object to data sharing clause in coroners bill
Authors: C. Dyer
Journal: BMJ (2009)

The UK government faces vociferous opposition to a measure tucked away in the Coroners and Justice Bill that would open the way for ministers to allow patients’ medical records to be used by researchers without the patients’ consent.

The Conservatives and Liberal Democrats strongly criticised clause 152 in the second reading debate on 26 January and pledged to try to have it thrown out. The Liberal Democrats’ justice spokesman, David Howarth, a Cambridge University law academic, described the provision as “outrageous” and said that its inclusion justified rejecting the bill as a whole.

The far reaching clause would amend the Data Protection Act and allow ministers to make information sharing orders that provide for personal data to be shared across government departments and outside government—as long as the move is in support of a government policy objective, …
Perils of the Patio Persist
Authors: Francis C. Lowell
Journal: New England Journal of Medicine (1974)

Years ago, there appeared in these pages an editorial on insect stings under the title "Perils of the Patio."1 Unquestionably, this had been enlivened by the deft hand of Dr. Garland, who was then editor of the Journal. Unfortunately, the title is still apt. As Lichtenstein, Valentine and Sobotka point out in their article in this issue, the clinical and immunologic problems related to treatment with extracts prepared from the stinging hymenoptera need more study.Allergic reactions to stings are closely related immunologically to hay fever and asthma as they occur in atopic persons allergic to pollens and animal . . .
THE GREAT MULTITUDE OF STUDENTS
Authors: None Fiasco
Journal: BMJ (1921)

Release of gonadotropin releasing hormone (GnRH) from the medial basal hypothalamus (MBH)/median eminence region (S-ME) is essential for normal reproductive function. GnRH release is profoundly regulated by the negative and positive feedback effects of ovarian estradiol (E<sub>2</sub>). Here we report that neuroestradiol, released in the S-ME, also directly influences GnRH release in ovariectomized female monkeys, in which the ovarian source of E<sub>2</sub> is removed. We found that (1) brief infusion of E<sub>2</sub> benzoate (EB) to the S-ME rapidly stimulated release of GnRH and E<sub>2</sub> in the S-ME of ovariectomized monkeys, (2) electrical stimulation of the MBH resulted in GnRH release as well as E<sub>2</sub> release, and (3) direct infusion of an aromatase inhibitor to the S-ME suppressed spontaneous GnRH release as well as the EB-induced release of GnRH and E<sub>2</sub>. These findings reveal the importance of neuroestradiol as a neurotransmitter in regulation of GnRH release. How circulating ovarian E<sub>2</sub> interacts with hypothalamic neuroestrogens in the control of GnRH release remains to be investigated.
SURGICAL MISTAKES IN INFANCY AND CHILDHOOD
Authors: SAMUEL WALTER KELLEY
Journal: JAMA (1910)

Not all the mistakes here related are of my own making, for which I am duly thankful. But many of them or their results have come under my own observation. Others have been related to me by my colleagues. The cases are, for the most part, not merely such as would in the adult present difficulties in diagnosis or in treatment; but they are such as are met only in the surgery of infancy and childhood, or in these periods of life present peculiarities when compared with corresponding conditions in the adult, and lead the practitioner unfamiliar with them into error. I have taken especial pleasure in presenting the illustrative cases furnished by my colleagues, because they show that the idea that mistakes in the surgery of infancy and childhood are altogether too common is entertained not by myself alone; they show also that the condition of ignorance of children's
Cameron launches challenge to end "national crisis" of poor dementia care
Authors: Z. Kmietowicz
Journal: BMJ (2012)

The prime minister has launched a three pronged approach to making the UK a world leader in dementia care—by improving the health and care of people with dementia, raising awareness about the condition to make communities more responsive to patients’ needs, and putting more resources into dementia research.

David Cameron said it was a national scandal that dementia was so poorly managed. “The level of diagnosis, understanding, and awareness of dementia is shockingly low. It is as though we’ve been in collective denial,” he said on 26 March at a conference organised by the Alzheimer’s Society.

His “dementia challenge” includes screening all those aged 65 to 74 for early signs of dementia as part of routine health checks for older people to detect cardiovascular disease, kidney disease, and diabetes. From April hospitals in England will be financially rewarded for checking people over 75 years admitted as emergencies …
Influence of augmented Hageman factor (Factor XII) titers on the cryoactivation of plasma prorenin in women using oral contraceptive agents.
Authors: E M Gordon, J Douglas, O D Ratnoff
Journal: Journal of Clinical Investigation (1983)

Prolonged cold storage of plasma may induce the conversion of plasma prorenin (inactive renin) to renin. This phenomenon is exaggerated in oral contraceptive (OC) users; the titer of Hageman factor (HF, Factor XII) in OC users is higher than in nonusers. The present study relates these observations. The increment in plasma renin activity (PRA) during cold storage, as measured by generation of angiotensin I, correlated strongly with the initial plasma titer of HF. Increasing the HF titer of nonusers to that observed in OC users by addition of purified HF increased cold-induced PRA at least twofold, while reducing the plasma HF titer of OC users correspondingly decreased cold-induced PRA. Thus, in OC users, the enhanced conversion of plasma prorenin to renin during cold storage reflects the elevated plasma titer of HF.Prolonged cold storage of plasma may induce the conversion of plasma prorenin (inactive renin) to renin. This phenomenon is exaggerated in oral contraceptive (OC) users; the titer of Hageman factor (HF, Factor 12) in OC users is higher than in nonusers. The present study relates these observations. The increment in plasma renin activity (PRA) during cold storage, as measured by generation of angiotensin I, correlated strongly with the initial plasma titer of HF. Increasing the HF titer of nonusers to that observed in OC users by the addition of purified HF increased cold-induced PRA at least 2-fold, while reducing the plasma HF titer of OC users correspondingly decreased cold-induced PRA. Thus, in OC users, the enhanced conversion of plasma prorenin to renin during cold storage reflects the elevated plasma titer of HF.
Vascular Surgery, vol 2: Peripheral Venous Diseases
Authors: Alan T. Marty
Journal: JAMA (1976)

Venous disease is ten times more common than peripheral arterial disease, but when compared to the excitement generated by recent advances in the management of arterial diseases, the subject of venous disease usually makes physicians either bored or bewildered. Both emotional reactions seem inappropriate after reading this book. For the bewildered, the author starts with basics. He approaches chronic venous insufficiency, for instance, by first labelling it an "incurable hydraulic abnormality." Because elastic compression will control the faulty hydraulics, 88% of venous ulcers can thereby be cured without surgery. The important point is that the patients must wear elastic support for life, just as those with optical abnormalities must wear glasses for life. Equally basic, stasis in the soleal venous plexus, the "main peripheral venous heart," is still the most common source of pulmonary emboli. In testifying to the force exerted by the soleal venous pump, the author offers a
SiRNA-loaded multi-shell nanoparticles incorporated into a multilayered film as a reservoir for gene silencing
Authors: Xin Zhang, Anna Kovtun, Carlos Mendoza-Palomares, Mustapha Oulad-Abdelghani, Florence Fioretti, Simon Rinckenbach, Didier Mainard, Matthias Epple, Nadia Benkirane-Jessel
Journal: Biomaterials (2010)
Should we screen for gestational diabetes? The case for screening for gestational diabetes
Authors: Jacqueline de A C Soares, Anne Dornhorstt, Richard W Beard
Journal: BMJ (1997)

Screening for gestational diabetes is imperative but we need to refocus away from short term improvements in obstetric outcomes to more important medium and long term health benefits. Today 5% of United Kingdom1 and 12% of United States2 total healthcare expenditure is spent on diabetes and its complications. There is a global epidemic of non-insulin dependent diabetes, and radical preventive measures are required if morbidity and mortality from diabetes are to fall. We would ask whether we can afford not to screen for gestational diabetes.

Detecting gestational diabetes identifies women at risk of future non-insulin dependent diabetes.3 4 The success of treating non-insulin dependent diabetes is severely hampered by the high percentage of diabetic complications present at diagnosis,5 so earlier diagnosis is important in preventing complications.6 Half of all people with non-inuslin dependent diabetes are clinically undiagnosed, and diagnosis takes, on average, seven years from onset of the disorder.7

The rate of progression to non-insulin dependent diabetes mellitus after a pregnancy where the woman has had gestational diabetes depends predominantly on ethnicity and the degree of glucose intolerance both in pregnancy and immediately afterwards.8 Other contributing factors are weight during pregnancy and subsequent weight gain, age, parity, and family history.8 9 In high risk populations, such as Hispanic American women, about 40% of women with gestational diabetes develop diabetes within six years, which rises to 70% among those with impaired glucose tolerance (by World Health Organisation criteria) after birth.10 In white Europeans the rate of progression to diabetes is slower—20-40% within 20 years.11 Identifying women who are at risk while they are still young provides an opportunity to identify the disease in subsequent pregnancies and to modify the natural …
Abstract 2135: TGFβRI inhibition results in reduced collagen expression in pancreatic ductal adenocarcinoma.
Authors: Clifford J. Whatcott, Sabrina N. Dumas, Aprill Watanabe, Janine LoBello, Daniel D. Von Hoff, Haiyong Han
Journal: Cancer Research (2013)

Abstract Pancreatic ductal adenocarcinoma (PDAC) is characterized by a robust stromal component termed the desmoplastic reaction. Transforming growth factor β (TGFβ) has been implicated in the activation of the cancer-associated fibroblast (CAF) that leads to pancreatic desmoplasia and the increased deposition of extracellular matrix proteins. Desmoplasia and its effects are thought to contribute to poor drug efficacy in PDAC treatment. We therefore hypothesized that TGFβ receptor (TGFβR) inhibition may serve to improve the activity of chemotherapeutics in PDAC by reducing the effects of desmoplasia. Using the TGFβRI inhibitors, LY2157299 and SB431542, we assessed the effects of TGFβR inhibition on cell proliferation and collagen production in both mono- and co-cultured pancreatic tumor cells and CAFs. We found that although the TGFβRI inhibitors had moderate effect on the proliferation of PDAC cells and co-cultured CAF cells, they significantly inhibited collagen 1 expression in the co-culture of MIA PaCa-2 and SU86.86 cells with CAFs (2.3 and 6.0-fold at the mRNA level, respectively). Similar qualitative reductions were also observed in immunofluorescence microscopy and immunoblots probing for collagen 1 protein levels. We also sought to determine if TGFβR inhibition would result in a reduction in collagen expression in the more biologically relevant in vivo model for PDAC, the LSL-KrasG12D/+;LSL-Trp53R172H/+;Pdx-1-Cre (KPC) mouse. KPC mice were treated orally, b.i.d., with 75mg/kg LY2157299 and by i.p., with gemcitabine (q3dx4) at 80mg/kg. Tumors in KPC mice treated with the combination of LY2157299 and gemcitabine showed a marked reduction in overall stromal content when compared to vehicle-treated mice. Our results suggest that TGFβR inhibition may be an effective means of ameliorating the effects of desmoplasia in PDAC, which may in turn improve the efficacy of current PDAC treatment regimens. Citation Format: Clifford J. Whatcott, Sabrina N. Dumas, Aprill Watanabe, Janine LoBello, Daniel D. Von Hoff, Haiyong Han. TGFβRI inhibition results in reduced collagen expression in pancreatic ductal adenocarcinoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2135. doi:10.1158/1538-7445.AM2013-2135
PSYCHIATRIC INTERVIEW EXPERIENCES WITH NEGROES
Authors: HARVEY R. ST. CLAIR
Journal: American Journal of Psychiatry (1951)

Some observations upon Negro psychiatric patients have been recorded. These observations were made clinically during personal interviews for psychotherapeutic purposes, and were done in the setting of the military service, a VA hospital, and a children's psychiatric service over a 3-year period. Most of the observations were with adult males, the majority of whom were from lower socioeconomic levels. It would seem that psychotherapy is not different with Negro patients than with white in respect to general principles and techniques, that the establishment of rapport, the use of the patient's agreeableness, the importance of dealing with hostility, and the use of promoting self-esteem are of special significance. Some features which have been recorded as clinical impressions are the frequency of functional illnesses, attitudes of suspiciousness and submissiveness, a constancy of race-consciousness, a difficulty in achieving expression of hostility toward the therapist, an agreeableness, an emphasis upon prestige for its security value, a tendency to "act out," a special emphasis upon hostility in individual psychodynamics, no racial differences in sexuality, an emphasis upon somatic complaints, and the importance of the therapist's recognizing socio-economic and cultural levels in individual patients. Some of the therapeutic implications of these features have been discussed. In general the impression has been gained that the various sociological and psychological factors of a minority group and a group whose socioeconomic level is lower must be given more consideration in the understanding of the Negro's symptomatology and therefore in treatment.
Resting angina with fixed coronary artery stenosis: nocturnal decline in ischemic threshold.
Authors: J Figueras, J Cinca, F Balda, A Moya, J Rius
Journal: Circulation (1986)

Atrial pacing was performed in 16 patients with angina at rest and significant coronary artery stenosis (greater than 70%) over 2 consecutive days in the morning (10 A.M. to 1 P.M.), in the afternoon (4 to 7 P.M.), and at night (12 midnight to 3 A.M.) to assess possible circadian variations of their ischemic threshold. Overall, the incidence of resting angina was highest at night. All pacing results were positive (greater than or equal to 1.0 mm ST segment shift) and tended to be reproducible in nine patients, whereas some or all were negative in seven. Among all positive results, ischemic thresholds at night were significantly lower than those in the morning and in the afternoon (125 +/- 3 vs 138 +/- 3 and 139 +/- 2 beats/min, mean +/- SEM; p less than .005). In nine patients, 19 pacing tests produced ST segment elevation, of which 13 were performed at night (68%). We conclude that patients with resting angina and severe coronary stenosis often exhibit a nocturnal decline in their ischemic threshold, which seems to facilitate development of transmural ischemia during atrial pacing.
The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration
Authors: Alessandro Liberati, Douglas G Altman, Jennifer Tetzlaff, Cynthia Mulrow, Peter C Gøtzsche, John P A Ioannidis, Mike Clarke, P J Devereaux, Jos Kleijnen, David Moher
Journal: Annals of Internal Medicine (2009)

Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (www.prisma-statement.org) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
Patterned growth of neonatal rat heart cells in culture. Morphological and electrophysiological characterization.
Authors: S Rohr, D M Schölly, A G Kléber
Journal: Circulation Research (1991)

A culture method was developed that permits patterning of the growth of ventricular myocytes of neonatal rats. Regions were created on the culture substrate that either prevented (photoresist coat) or supported (glass surface) attachment of cells. In this way the geometry of interconnecting growth channels could be specified. Single-layered myocyte strands of variable length and with widths of as little as 65 micron (three to four cells wide) were obtained. The shape and orientation of the individual myocytes were a function of growth-channel width: the narrower the channel, the more elongated the cells and the more likely was the long axis to be oriented along the channel axis. In channels with width of 100 micron or less, cells were aligned longitudinally and cross-striated as in vivo. A high degree of morphological cell differentiation required the presence of contractile activity. Maximal diastolic potential (-71 mV), action potential amplitude (93 mV), and maximal upstroke velocity (140 V/sec) did not change with increasing culture age. Mean longitudinal conduction velocity was 0.39 m/sec. No electrophysiological or morphological evidence of photoresist toxicity was seen, and the data indicate a high degree of cell differentiation in the patterned cell cultures. The method thus is suitable for the study of the relation between impulse propagation and structure at a cellular level in artificial networks of predefined shape.
GIDEON: Global Infectious Disease and Epidemiology Network
Authors: Vincent J. Felitti
Journal: JAMA (1997)

Anyone who has never used a good artificial intelligence program would do well to start at the top with GIDEON. Global Infectious Disease and Epidemiology Network is a superb example of artificial intelligence applied to medicine. Given modern air transportation, the most ordinary of patients now can be recently returned from the most extraordinary of places, exposed to infectious diseases one has not even heard of, much less is knowledgeable about. What infectious diseases are relevant to a fly fisherman returning febrile from the Chilean Andes or to a Coca Cola salesman returning with a nonhealing skin ulcer from Siberia? Problems once in the domain only of university specialists now are seen in the offices of medical practitioners throughout the country.  GIDEON is designed to diagnose all the world's infectious diseases (over 300) from over 200 countries, based on the symptoms, signs, and laboratory findings that you enter for your
CEA monitoring in colorectal cancer is not a waste of time
Authors: D. Mant, J. Primrose
Journal: BMJ (2014)

This “cautionary tale” about follow-up of patients after treatment of colorectal cancer drew attention to newly published data from a trial started in 1982 that showed “no hint of a survival advantage associated with knowledge of CEA [carcinoembryonic antigen].1 2 The article said: “The Follow-up After Colorectal Surgery (FACS) trial, recently published in JAMA , confirmed the lack of survival benefit, finding a higher death rate in patients who were intensively monitored.”3

As lead authors of the JAMA …
Higher pH level, corresponding to that on the skin of patients with atopic eczema, stimulates the release of <i>Malassezia sympodialis</i> allergens
Authors: C. Selander, A. Zargari, R. Möllby, O. Rasool, A. Scheynius
Journal: Allergy (2006)

Background: The opportunistic yeast Malassezia is a trigger factor in atopic eczema (AE). Around 30–80% of patients with AE have an IgE and/or T‐cell reactivity to the yeast. Several IgE‐binding components have been identified in Malassezia extracts and 11 allergens have been cloned and sequenced. The pH of the skin surface in patients with AE is higher than that of normal healthy skin. We here investigate whether different pH conditions mimicking those of AE skin and healthy skin can influence the production and release of Malassezia allergens. Methods: Malassezia sympodialis (ATCC strain 42132) was cultured in Dixon broth at pH 6.1 to 5.0 for 1–15 days. Culture supernatants were analysed for the presence of IgE‐binding components by immunoblotting. The M. sympodialis cells were analysed for allergen expression and production with immunocytochemistry and quantitative polymerase chain reaction. Results: We found that M. sympodialis cells produce, express and release allergens to a greater extent when cultured at the higher pH. This was particularly true of a 67‐kDa major allergen designated Mala s 12. Conclusions: The data suggest that the skin barrier in AE patients provides an environment that can enhance the release of allergens from M. sympodialis , which can contribute to the inflammation.
Bayes's theorem and the evaluation of tests
Authors: G. W Partridge
Journal: BMJ (1980)

doses of chlorpromazine intravenously had an initial reduction in high pressure that was followed by a severe pressure drop and a fatal outcome.We feel like Dr Young and colleagues that the hypotensive effect of phenothiazines, to which group chlorpromazine belongs, is not well known among physicians, and we once again would caution against too high initial doses of these drugs when used in emergency treatment of severe hypertension.