tbuckley/cabot-search huggingface dataset:
Intermittent Bleeding in a Patient with Multiple Ulcerations Near the Terminal lleum Visualized on Tc-99m RBC Gastrointestinal Imaging
Authors: SEIICHIRO MORITA, MASATOSHI ISHIBASHI, TAKANOBU HIRAYAMA, KAZUYUKI TAKAHASHI, YASUSHI NOMURA, HISASHI OHTAKE
Journal: Clinical Nuclear Medicine (1990)

A 50-year-old man with intestinal bleeding caused by multiple ulcerations near the terminal ileum is presented. Abdominal scanning with Tc-99m labeled RBCs demonstrated intermittent bleeding in short intervals. Selective angiography did not demonstrate the bleeding site. Exploratory laparotomy showed three ulcers at a site near the terminal ileum, one of which was bleeding. In this case, Tc-99m RBC abdominal scanning was very useful in the detection of the site of gastrointestinal bleeding before laparotomy.
Monitoring of psychotropic drug prescribing in general practice.
Authors: D L Crombie
Journal: BMJ (1979)

of them,4 we suggest, is irrelevant and another two, from signatories to this letter,5 (i did in honesty mention this as a possibility without substantiating it with any evidence.In fact, in all our work with oral methionine in paracetamol poisoning we have never found any toxicity from it whatsoever.In conclusion, we are happy to leave it to your readers to make up their own minds on the facts before them.After all, it is almost a question of "you pays your money and takes your choice."In these days of economic stringency, above all in the National Health Service, it might be worth mentioning that the course of oral methionine that we recommend in these circumstances will attract a charge of some 80p whereas the corresponding course of N-acetylcysteine as a "special intravenous preparation (Parvolex, Duncan Flockhart)" will cost more than £30.
A Case of Abscess of the Brain
Authors: J. K. Spender
Journal: BMJ (1868)

Surgeon to the Mineral Water Hospital, and to the Eastern Dispensary, Bath THE following case possesses some interest and value, on account of the complete history which was obtained.Some points in that history, too, may help to place the diagnosis of cerebral abscess on a surer foundation.G. T., a well-built muscular man, aged 6o, by occupation a carter, and in apparently sound and even vigorous health, fell off a load of thorns in the middle of November I866, and struck the back of his head.He was severely shaken, but was not made insensible.He did not vomit; and there was no outward injury inflicted on the body, beyond bruises.He stayed at home quietly for four days, and then went to work again; but, for many days after this, he always came home early, and, in a silent moody way, sat shivering all the evening over the fire.He often went to bed as early as seven o'clock, and said that he had a noise in his head like "singing".All through January, he stayed at home entirely, and was always silent and strange.The people around him had to speak two or three times before they could get an answer.This wvent on through February and nearly the whole of March.On March 28th, he felt so much better, that he went to a wood with two or three other men, in order to fell trees; and, while doing this, he had a " fit"-strictly epileptiform, for he was insensible and con.vulsed, and was brought home by his companions.Next morning, he was so far revived, that he resumed the work of the previous day, and did so until Monday, April ist, when he came home about noon, and did not go out again all the week.It was on Wednesday, April 3rd, that he was seen for the first time by the house-surgeon of the Eastern Dispensary, Mr. Exell.On Sunday evening, April 7th, he was re- markably lively and cheerful.
Three-Dimensional Modeled Custom-made Noninvasive Positive Pressure Ventilation Masks in an Infant
Authors: Allison Carroll, Israel Amirav, Roger Marchand, Deb Olmstead, Heather Logan, Andrew Grosvenor, Carina Majaesic, Joanna MacLean, Piush J. Mandhane
Journal: American Journal of Respiratory and Critical Care Medicine (2014)
Regular balloon inflation for patients with chronic bronchitis: a randomised controlled trial.
Authors: A. J. Chauhan, J. P. McLindon, P. Dillon, J. P. Sawyer, L. Gray, B. C. Leahy
Journal: BMJ (1992)

Preterm labour continues to complicate a substantial number of pregnancies, and preterm delivery accounts for most early neonatal deaths not due to congenital abnormalities.' Ritodrine hydrochloride, a 13 sympathomimetic agent with predominant effects on 0 receptors such as those of the uterus,2 is effective in suppressing premature uterine contractions.2We describe six pregnant women given ritodrine hydrochloride who developed swelling of the salivary glands with hypersecretion of amylase.
A Randomized Trial of Nicotine Enemas for Active Ulcerative Colitis
Authors: John R. Ingram, Gareth A.O. Thomas, John Rhodes, John T. Green, Neil D. Hawkes, Jill L. Swift, Emmanuel D. Srivastava, Brian K. Evans, Geraint T. Williams, Robert G. Newcombe, Edward Courtney, Suresh Pillai
Journal: Clinical Gastroenterology and Hepatology (2005)
Massive Hemorrhage Caused by a Perforating Gianturco-Z Stent Resulting in an Aortoesophageal Fistula
Authors: P. D. Siersema, T. G. Tan, F. F. J. M. Sutorius, J. Dees, M. van Blankenstein
Journal: Endoscopy (1997)

Endoscopic placement of self-expanding metal stents is regarded as a safe and effective method of palliating obstructive esophageal malignancies. We report here the case of a 49-year-old woman with an inoperable squamous-cell carcinoma located in the mid-esophagus. After two courses of chemotherapy, a silicone-covered Gianturco-Z stent was placed because of progressive tumor growth. Eighteen days after the stent placement, the patient presented with hematemesis, and died 24 hours after admission. At autopsy, the proximal end of the stent was found to have perforated through the normal esophageal mucosa into the aorta, resulting in an aortoesophageal fistula. This complication should be considered in patients who present with massive hemorrhage after undergoing radiotherapy or chemotherapy, or both, before stent placement in the mid-esophagus.
Individual variation in plasma cholesterol response to dietary saturated fat
Authors: C. Cox, J. Mann, W. Sutherland, M. Ball
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To determine the extent to which plasma lipid concentrations of individuals are consistently sensitive to changes in saturated fats; to examine whether groups that consistently have large or small responses can be defined; and to identify factors which predict response of lipids to dietary change. <b>Design</b>: A double crossover design in which two diets (S, providing 21% energy from saturated fat, and P, providing 10%) were followed for periods of six weeks in the sequence SPSP or PSPS. <b>Setting</b>: 67 free living subjects, total cholesterol 5.5-7.9 mmol/l. <b>Main outcome measures</b>: Relation of cholesterol responses to repeated dietary changes and of potential predictors and cholesterol response. <b>Results</b>: Similar average changes in cholesterol mask a wide range of individual responses. Response was not related to compliance. In all participants the change in cholesterol observed when the nature of dietary fat was changed on the two crossovers was correlated (r=0.31, P=0.01); the degree of correlation between the two sets of responses was greater in the 46 consistent responders than in the 21 variable responders (r=0.71 v r=0.21). Mean differences in cholesterol between diet S and diet P during the two crossovers were 1.16 (SD 0.35) mmol/l and 0.95 (0.26) mmol/l for consistent hyperresponders and 0.18 (0.26) mmol/l and 0.18 (0.25) mmol/l for consistent minimal responders. In consistent responders, changes in total cholesterol in response to increasing saturated fats correlated with baseline cholesteryl ester transfer activity (r=0.32, P=0.03); total cholesterol (r=0.37, P=0.01); triglycerides (r=0.30, P=0.04); and apolipoprotein B (r=0.54, P=0.01). <b>Conclusions</b>: There is a degree of consistency in cholesterol response to instructions to change dietary fat which is not explained by dietary compliance, and there are groups of consistent hyperresponders and minimal responders within a population of hypercholesterolaemic individuals. Several factors predicting response have been identified. These results have relevance to dietary approaches aimed at reducing the lipoprotein mediated risk of coronary heart disease.
AMBLYOPIA EX ANOPSIA, WITH CASE.
Authors: A. C. SIMONTON
Journal: JAMA (1898)

The only apology that need be offered for presuming to discuss the question of amblyopia ex anopsia before this learned section of theAmerican Medical Associationis to state the existing fact that in this year 1897 there are eminent ophthalmologists who deny the possibility of the occurrence of the said condition. It would seem that this question should have been definitely settled long since, but it was discussed extensively,<i>pro</i>and<i>con</i>, at the meeting of thisAssociationin 1893, and at this meeting we are to have some more<i>pros</i>and<i>cons</i>, no doubt. How any ophthalmologist who observes closely, thinks clearly and weighs well the terms he is using, will venture to assert that there is no such condition as amblyopia ex anopsia I shall not attempt to explain. While it is a fact that it has not fallen to the good fortune of many oculists to
Nine Cases of Successful Operations for Ruptured Tubal Pregnancy
Authors: L. Tait
Journal: BMJ (1885)

often readily slips into the bladder; at the same time, its free and my movement in the urethra, together with the sensations experienced by the patient, clearly indicate to the surgeon that the stricture has been overcome, and the catheter coaxed to move on in the right direction.The discharge of a little urine now takes place, the dis- tended bladder is soon relieved, the urethral spasm subsides, and the power of expulsion is re-established.The urine soon flows in suc- essive jets through the tube, and also by its side, and, within a few
India's health insurance plans encourage a hospital centred system, World Bank says
Authors: G. Mudur
Journal: BMJ (2012)

Health insurance programmes in India funded by the government are delivering inpatient healthcare to millions of low income households, but are encouraging a hospital centred healthcare delivery system, and even “unneeded care,” a World Bank report has said.

The report, released last week, has analysed health insurance programmes in India launched by the central and various state governments over the past five years that have increased the population covered by health insurance from 75 million in 2007 to 300 million by 2010.

The insurance initiatives have “helped improve financial access to inpatient care for low income populations” for health conditions that might have gone untreated, World Bank health specialists Gerard La Forgia and Somi Nagpal said in their report.1

“We see some unique features of these schemes—they follow a bottom up design that starts with the poor, …
Inflammatory, Hemostatic, and Other Novel Biomarkers for Diabetic Retinopathy
Authors: Thanh T. Nguyen, Ekaterina Alibrahim, F.M. Amirul Islam, Ronald Klein, Barbara E.K. Klein, Mary Frances Cotch, Steven Shea, Tien Y. Wong
Journal: Diabetes Care (2009)

OBJECTIVE There are conflicting data regarding relationships of systemic biomarkers of inflammation, hemostasis, and homocysteine with diabetic retinopathy. We examined these relationships in the Multi-Ethnic Study of Atherosclerosis. RESEARCH DESIGN AND METHODS A total of 921 participants with diabetes were included. Diabetic retinopathy was graded from retinal photographs. We defined two outcomes: any diabetic retinopathy and vision-threatening diabetic retinopathy (severe nonproliferative diabetic retinopathy or worse). Systemic markers analyzed were C-reactive protein, homocysteine, fibrinogen, plasmin-α2-antiplasmin complex (PAP), interleukin-6, d-dimer, factor VIII, serum creatinine, and urinary albumin-to-creatinine (UAC) ratio. RESULTS Prevalence of diabetic retinopathy was 33.2% and vision-threatening diabetic retinopathy 7.1%. After adjusting for established risk factors (diabetes duration, A1C, systolic blood pressure, waist-to-hip ratio, and use of diabetes medications), fibrinogen (odds ratio 1.14 [95% CI 1.01–1.32], P = 0.05) and PAP (1.25 [1.05–1.50], P = 0.01) were associated with any diabetic retinopathy, while PAP (1.54 [1.13–2.11], P = 0.007) and homocysteine (1.57 [1.16–2.11], P = 0.003) were associated with vision-threatening diabetic retinopathy. Only PAP remained significant after additional adjustment for serum creatinine and UAC ratio. Area under receiver-operator characteristic curve (AUROC) for diabetic retinopathy was constructed for established and novel risk factors. Established risk factors accounted for a 39.2% increase of the AUROC, whereas novel markers (fibrinogen, PAP, homocysteine, serum creatinine, and UAC ratio) only accounted for an additional 2.2%. CONCLUSIONS There were few associations of novel markers of inflammation, hemostasis, and homocysteine with diabetic retinopathy after controlling for established risk factors. These data suggest that there is limited clinical use of these biomarkers for prediction of diabetic retinopathy.
Purchasers should require providers to set standards for pain relief
Authors: W. G Notcutt
Journal: BMJ (1997)

Editor–The sad tale by Matthew Juniper, a young rugby player, about the six weeks he spent in hospital after he injured his leg shows the continuing lack of adequate knowledge of pain relief.1 Undergraduate and postgraduate education in pain relief remains inadequate, and it is time that we set standards.

The …
β-Blockers and Sudden Cardiac Death
Authors: Martin J. Kendall
Journal: Annals of Internal Medicine (1995)

Objectives: To 1) consider the problem of sudden death from heart disease and the role of β-blockers and other agents in preventing sudden death and 2) review perceived problems with β-blocker therapy, such as effects on blood lipids, complications in diabetes, and adverse effects on heart failure and quality of life. Data Sources: MEDLINE and EMBASE searches done from July 1994 on, and recognized texts. Study Selection: More than 400 original and review articles were evaluated, of which the most relevant were selected. Data Extraction: Data were extracted and reviewed by two authors. Accuracy was confirmed, when necessary, by the other authors. Data Synthesis: Of all of the therapies currently available for the prevention of sudden cardiac death, none is more established or more effective than β-blockers. Indeed, the evidence that β-blockers have a cardioprotective effect is compelling. They probably reduce the rate of atheroma formation; they reduce the risk for ventricular fibrillation in animal models of myocardial ischemia; they appear to reduce cardiac mortality in primary prevention trials; and they reduce mortality, particularly from sudden death, in patients who have had infarction. Moreover, withholding β-blockers because of problems perceived to be associated with them is usually not warranted and may frequently prevent their use in those who will benefit most from them. Conclusion: Clinicians should reappraise the evidence for the significant effect of β-blockers on morbidity and mortality, and they should recognize the importance of initiating and maintaining β-blocker therapy when the less well-informed might suggest other-wise.
A mutation that causes lability of the androgen receptor under conditions that normally promote transformation to the DNA-binding state.
Authors: W J Kovacs, J E Griffin, D D Weaver, B R Carlson, J D Wilson
Journal: Journal of Clinical Investigation (1984)

Dihydrotestosterone-receptor complexes formed in human fibroblast cytosol prepared at 0 degrees C in the presence of sodium molybdate can be readily transformed to the DNA-binding state by heating at 25 degrees C. Under these conditions 50-70% of dihydrotestosterone-receptor complexes bind to DNA. We describe here studies of the transformation process in cytosols derived from normal cells and from fibroblasts propagated from subjects with syndromes of androgen resistance. In contrast to the situation with dihydrotestosterone, normal testosterone-receptor complexes are unstable under in vitro transforming conditions. Although equal amounts of hormone-receptor complex are formed at 0 degrees C, only 15% of testosterone-receptor complexes remain stable and acquire DNA-binding capacity after warming. This instability is not reversible upon lowering the temperature and is corrected by low concentrations (0.25 microM) of the protease inhibitor leupeptin. We have also identified two cousins with androgen resistance whose androgen-receptor complexes exhibit similar in vitro transformation lability with both dihydrotestosterone and testosterone. Phenotypic evidence in these subjects indicates that dihydrotestosterone-mediated processes are more completely impaired than are testosterone-mediated events. These findings suggest that dihydrotestosterone may amplify the androgenic signal at its targets not only by its higher affinity for the receptor but also by its more efficient conversion to the DNA-binding state and that such amplification may be less critical in target tissues in which testosterone suffices for androgenic effect. This offers one possible explanation of how a mutation that affects a single receptor protein may differentially impair the actions of two binding ligands of the receptor.
Comment on: Effect of a nicotine-free inhalator as part of a smoking cessation programme
Authors: K. Fagerström
Journal: European Respiratory Journal (2012)

From the authors:

We are pleased that our recent work published in the European Respiratory Journal regarding the positive role of a nicotine-free inhalator (Paipo; Echos Srl, Milan, Italy) used in the context of smoking cessation interventions [1] has attracted so much interest. In particular, we are grateful to K. Fagerstrom and C.N. Meyer for raising a number of stimulating and relevant points. A pronounced effect on quit rates was observed with Paipo in smokers with a supposedly high degree of behaviour dependence to smoking ( i.e. in those for whom handling and manipulation of their cigarettes played an important part in the ritual of smoking). This was measured by the Glover–Nilsson Smoking Behavioral Questionnaire (GN-SBQ), which determines the importance of the behaviour component in smoking dependence [2].

Based on the current knowledge of predictors of smoking cessation [3], the pronounced effect on quit rates observed with Paipo in the participants with high behaviour dependence to smoking was surprising. There may be several explanations for this. Using a different cut-off point on the GN-SBQ scale might have affected results, but we have followed the recommendations of the GN-SBQ developers and used the canonical cut-off point of 22 for the analyses [2]. Alternatively, our findings reflect the fact that aspects …
Tissue screening after breast reduction
Authors: M. Keshtgar, A. H. Jahromi, T. Davidson, P. Escobar, P. Mallucci, A. Mosahebi, M. Baum
Journal: BMJ (2009)

Patients who undergo breast reduction surgery have a low risk of being found to have breast cancer, but they need to be made aware of it—and doctors need to debate whether routine histological examination of tissue specimens is a good idea. We sought the views of Tom Treasure, a surgeon (doi:10.1136/bmj.b759), Jeremy Sugarman, an ethicist (doi:10.1136/bmj.b753), and Tessa Boase, a lay person (10.1136/bmj.b776)
Subcellular mislocalization of the transcription factor NF-E2 in erythroid cells discriminates prefibrotic primary myelofibrosis from essential thrombocythemia
Authors: Konrad Aumann, Anna-Verena Frey, Annette M. May, Dieter Hauschke, Clemens Kreutz, Jan P. Marx, Jens Timmer, Martin Werner, Heike L. Pahl
Journal: Blood (2013)
Protection against autonomic denervation following acute myocardial infarction by preconditioning ischemia.
Authors: T Miyazaki, D P Zipes
Journal: Circulation Research (1989)

To examine the effects of ischemic preconditioning on efferent autonomic responses following acute transmural myocardial ischemia/infarction (MI), the time course and extent of efferent sympathetic and vagal denervation were compared between control dogs that received a one-stage sustained coronary occlusion and preconditioned dogs that received four 5-minute coronary occlusions separated by 5 minutes of reperfusion before sustained occlusion. Effective refractory periods (ERP) basal and apical to MI were determined in the baseline state and during neural stimulation before and after preconditioning occlusions and 20, 60, 120, and 180 minutes after sustained occlusion by ligature ligation of diagonal branches of the left anterior descending coronary artery. In 10 control dogs with transmural MI, ERP shortening induced by bilateral ansae subclaviae stimulation (4-msec pulses, 2-4 Hz and 2-4 mA) was unchanged at basal sites but was attenuated at apical sites. Four of 40 apical test sites exhibited efferent sympathetic denervation (less than or equal to 2 msec shortening) 20 minutes after sustained occlusion. Thirteen of 40 apical sites became denervated during a 3-hour period. In 10 preconditioned dogs, ERP shortening at apical sites was unchanged after preconditioning occlusions and during the first 60 minutes of sustained ischemia but was attenuated at 120 minutes. Three of 40 apical test sites became denervated during a 3-hour period. The cumulative percentage of denervated apical test sites was significantly less in the preconditioned group compared with the control group (p = 0.006) despite a comparable degree of subepicardial involvement in the MI (8.2 +/- 1.0% vs. 8.4 +/- 1.4%, the ratio to the left ventricular circumference, mean +/- SEM). In 11 control dogs tested for efferent vagal response after MI, ERP prolongation induced by bilateral vagal stimulation (4-msec pulses, 20 Hz with current strength 0.05 mA greater than that required to produce asystole) was unchanged at basal sites, but was attenuated at apical sites, and five of 44 test sites exhibited denervation (less than or equal to 1 msec prolongation) 20 minutes after sustained coronary occlusion. Fourteen of 40 apical sites became denervated during a 3-hour period. In 10 preconditioned dogs, vagally induced ERP prolongation was unchanged both at basal and apical sites, and none of 36 apical test sites exhibited denervation after preconditioning and during a 3-hour period of sustained coronary occlusion (p less than 0.001 vs. control group) despite a comparable degree of subendocardial involvement in the MI (11.8 +/- 0.8% vs. 11.9 +/- 1.3%).(ABSTRACT TRUNCATED AT 400 WORDS)