tbuckley/cabot-search huggingface dataset:
Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial
Authors: Odd-Egil Olsen, Grethe Myklebust, Lars Engebretsen, Ingar Holme, Roald Bahr
Journal: BMJ (2005)

Objective To investigate the effect of a structured warm-up programme designed to reduce the incidence of knee and ankle injuries in young people participating in sports. Design Cluster randomised controlled trial with clubs as the unit of randomisation. Setting 120 team handball clubs from central and eastern Norway (61 clubs in the intervention group, 59 in the control group) followed for one league season (eight months). Participants 1837 players aged 15-17 years; 958 players (808 female and 150 male) in the intervention group; 879 players (778 female and 101 male) in the control group. Intervention A structured warm-up programme to improve running, cutting, and landing technique as well as neuromuscular control, balance, and strength. Main outcome measure The rate of acute injuries to the knee or ankle. Results During the season, 129 acute knee or ankle injuries occurred, 81 injuries in the control group (0.9 (SE 0.09) injuries per 1000 player hours; 0.3 (SE 0.17) in training v 5.3 (SE 0.06) during matches) and 48 injuries in the intervention group (0.5 (SE 0.11) injuries per 1000 player hours; 0.2 (SE 0.18) in training v 2.5 (SE 0.06) during matches). Fewer injured players were in the intervention group than in the control group (46 (4.8%) v (76 (8.6%); relative risk intervention group v control group 0.53, 95% confidence interval 0.35 to 0.81). Conclusion A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. Preventive training should therefore be introduced as an integral part of youth sports programmes.
Microscopic Diagnosis of the Parasites of Man
Authors: J. Walter Beck
Journal: JAMA (1965)

Designed primarily for the laboratory technician in diagnostic parasitology but useful as well to the practicing physician confronted with parasitological problems, this book is timely. The jet age with its rapid dispersal of people over the globe has brought the problems of diagnostic parasitology to every laboratory of every clime. Most texts of parasitology, however useful to the academician and physician, frequently fail to meet the needs of the laboratory worker who must isolate and identify the parasites and face the associated problems and pitfalls. The author has successfully presented, in clear and detailed form, the facts and artifacts of microscopical diagnosis of the parasitic diseases in man. Though experienced parasitologists might disagree on some esoteric details emphasized by the author, the presentation of several points of view leaves the technician free to explore for himself the efficacy of the methods involved. Omissions are few, the most glaring being the
SIGNIFICANT DIFFERENCE IN APPROPRIATE USE CRITERIA SCORES FOR OUTPATIENT SPECT MYOCARDIAL PERFUSION IMAGING BASED ON AGE, GENDER, ETHNICITY, SITE AND ORDERING PHYSICIAN
Authors: Narendra Singh, Amit N. Amin, Sandeep Chandra, David Song, Linda Yan, David Suh
Journal: Journal of the American College of Cardiology (2013)
Management of Malignant Hypertension Complicated by Renal Insufficiency
Authors: James W. Woods, William B. Blythe, William D. Huffines
Journal: New England Journal of Medicine (1974)

Aggressive hypotensive-drug therapy combining a thiazide diuretic, hydralazine and guanethedine was used in 20 patients with malignant hypertension complicated by renal insufficiency. Eleven of the patients lived for one year, four for five years, and two for 7 1/2 years. One is still alive beyond eight years. The glomerular filtration rate remained stable at low levels for long periods in some of the patients. Eleven died of uremia. In patients surviving for only weeks or months, the arterioles and small arteries were most affected, whereas in those surviving for at least one year, the large arteries revealed the more striking pathological changes. We conclude that aggressive reduction of blood pressure does not necessarily result in deterioration of renal function and may prolong survival. (N Engl J Med 291:10–14, 1974)
The role of the eae gene of enterohemorrhagic Escherichia coli in intimate attachment in vitro and in a porcine model.
Authors: M S Donnenberg, S Tzipori, M L McKee, A D O'Brien, J Alroy, J B Kaper
Journal: Journal of Clinical Investigation (1993)

The eaeA gene of enteropathogenic Escherichia coli (EPEC) is necessary for intimate attachment to epithelial cells in vitro.Enterohemorrhagic E. coli (EHEC) strains also possess an eac gene and are capable of intimate attachment and microvillus effacement in vitro and in animal models.To assess the role of the EHEC eae gene in intimate attachment, we constructed an eae deletion/insertion mutation in wild-type EHEC 0157:H7 strain 86-24 by using linear electroporation of a recombinant allele.The mutant obtained was deficient in inducing f-actin accumulation in HEp-2 cells and was incapable of attaching intimately to colonic epithelial cells in a newborn piglet model of infection.Intimate attachment in vivo was restored when the EHEC eae gene or the eaeA gene of EPEC was introduced into the mutant on a plasmid.These results indicate that the eae gene is necessary for intimate attachment of EHEC in vivo.In addition, the complementation achieved by the EPEC locus indi- cates that the eae gene of EHEC and the eaeA gene of EPEC are functionally homologous.(
Remodeling of Left Ventricular Hypertrophy in Elite Athletes After Long-Term Deconditioning
Authors: Antonio Pelliccia, Barry J. Maron, Rosanna De Luca, Fernando M. Di Paolo, Antonio Spataro, Franco Culasso
Journal: Circulation (2002)

Background— The clinical significance and long-term consequences of left ventricular (LV) hypertrophy associated with intensive athletic conditioning remain unresolved. Methods and Results— We prospectively evaluated 40 elite male athletes who had shown marked LV cavity enlargement of ≥60 mm, wall thickness of ≥13 mm, or both in a longitudinal fashion with serial echocardiograms, initially at peak training (age 24±4 years) and subsequently after a long-term deconditioning period (1 to 13 years; mean, 5.6±3.8). After detraining, LV cavity dimension decreased by 7% (61.2±2.9 to 57.2±3.1 mm; P &lt;0.001), maximum wall thickness by 15% (12.0±1.3 to 10.1±0.8 mm; P &lt;0.001), and mass normalized to height by 28% (194±25 to 140±21 g/m; P &lt;0.001). However, individual subject analysis showed persistent substantial cavity dilatation (≥60 mm) in 9 athletes (22%); in contrast, wall thickness returned to normal in each athlete. Multiple regression analysis demonstrated that approximately 50% of the incomplete reduction in cavity dimension was explained by increased body weight and recreational physical activity performed during the follow-up period. No athlete had developed cardiac symptoms, impaired exercise performance, or evidence of LV dysfunction. Conclusions— LV remodeling was evident after long-term detraining, with significant reduction in cavity size and normalization of wall thickness. Resolution of cavity enlargement was, however, incomplete in most cases, and substantial chamber dilatation persisted in &gt;20% of athletes. The possibility that this residual LV hypertrophy, apparently part of the athlete’s heart syndrome, may have future long-term clinical implications in some individuals cannot be excluded with certainty.
Sexual expression in paraplegia.
Authors: P Oakeshott
Journal: BMJ (1990)

because they contain added iron and vitamin D and have limited saturated fat and sodium contents, without limiting energy content.Regarding cost we can quibble over figures, but let's accept an extra cost ofE l.43 a week of using a follow on milk (or infant formula) instead of cows' milk.This is the equivalent each day of one to two disposable nappies, or a newspaper, or two cigar- ettes, or 28 ml beer.Nevertheless, for some families even this extra cost may be the proverbial straw-but the answer to this is to change other aspects of public policy, not to continue to recom- mend substandard child feeding customs that are being abandoned by many other countries in the developed world.
POST-MORTEMS: THEIR OBJECT AND PERFORMANCE
Authors: E. F. Hoare
Journal: BMJ (1931)

In this matter there is a natural bias oIn the general practitioner's part to resent the snatching from him of another portion of what has been pessimistically described as " all that is left to him " in an age of specialization.As a G.P. for over 20 years I sympathize with this attitude, and I feel somewhat of a " Judas" should I appear to be on the other side; and yet, perhaps just because of this instinctive general-practitioner prejudice which only reluctantly yielded to knowledge and experience, I hope my remarks may be regarded as adverse rather than hostile.Judging from the correspondence which appeared in the British Medical Journal in August, 1930, by " Rusticus " and others in later numbers, and from my own experience, the wish to do post-mortem examinations is often more a theoretical protest than a practical desire.I have beeni begged by practitioners not to give them this work.Others do them as " a messy job," not so much for the fee but as a protest at being deprived of the work and its fee.A few are eager for the work.But all three groups invariably preface their examination with a very pregnant remark, namely, "It's several years since I last did a p.m." VJESTED INTERESTSPathologists naturally feel that the examination of the cadaver is their work, and, in so far as a pathologist's scope of work usually involves not competing with others in prac- tice and the frequent examination of morbid tissues in the living and dead, this seems a logical and just contention.The fact that a pathologist is ipso facto not a potential competitive practitioner must, financially at least, more than compensate the general practitioner for the occasional fee he loses by the pathologist taking-this work.
Carcinoma of Vulva
Authors: D. L. Dey
Journal: BMJ (1954)

<h3>Background</h3> Many cardiac conditions, including electrophysiologic, ischaemic, or heart failure, are characterised by a risk of sudden and disabling symptoms. For this reason, inpatient cardiology admissions can affect a patient’s eligibility to drive, according to driver and vehicle licensing agency (DVLA) rules. Appropriate advice has serious patient quality of life, patient and public safety, and medicolegal implications. Despite this, our own experience, and existing data, suggested that provision of advice was often informal, inaccurate, or omitted altogether. <h3>Methods</h3> We conducted a baseline audit of 28 consecutive days of discharge letters against four process measures to establish the frequency and quality of documentation of discharge driving advice for patients discharged from our cardiac care unit. Subsequently, we implemented a quality improvement project (QIP) with prospective patient-centred primary outcome measures. Over six plan-do-study-act (PDSA) cycles, we iteratively designed a standard operating procedure (SOP) for consultant-led discharge driving advice, supported by patient and staff posters, whiteboard magnets and nursing checklists, and a smartphone ‘app’. Following the QIP, we audited a second period of 28 consecutive days of discharge letters against the same four process measures to assess lasting change. <h3>Results</h3> Baseline audit established that, of 115 consecutive patients, 74 had a diagnosis that could affect their driving eligibility. Of these, one (1.4%) had appropriate documentation of discharge driving advice. Qualitative data collected prospectively throughout the QIP showed positive patient experience and accurate patient understanding as new operating procedures were implemented. Repeat audit of 124 consecutive patients following intervention identified 81 patients who had a diagnosis that could affect their driving eligibility, of whom 36 (44.4%) had appropriate documentation of discharge driving advice. <h3>Conclusion</h3> Discharge driving advice is relevant to most cardiology inpatient admissions, and yet was rarely documented. A simple SOP for consultant-led discharge driving advice was developed using PDSA methodology, which was well-received by patients and, following re-audit, demonstrated a lasting improvement in documented advice. <h3>Conflict of Interest</h3> None to declare.
Stereoselective Interaction of Trimethoprim-Sulfamethoxazole with the Separated Enantiomorphs of Racemic Warfarin in Man
Authors: Robert A. O'Reilly
Journal: New England Journal of Medicine (1980)

IN a previous study of the interaction between racemic warfarin (a mixture of the levorotatory and dextrorotatory enantiomorphs) and trimethoprim–sulfamethoxazole (TMP-SMZ) in man, marked augmentat...
Roole of carcinoembryonic antigen in bronchial carcinoma.
Authors: C H Ford, C E Newman, J Lakin
Journal: Thorax (1977)

It has been reported that lung cancer patients often have raised carcinoembryonic antigen (CEA) levels but the significance of this in diagnosis and follow-up has yet to be established. The results of 256 preoperative investigations in patients with lung cancer are reported. Sequential values after radical surgery and chemotherapy and immunotherapy have been performed in 57 patients during treatment and outpatient follow-up. Ninety-nine per cent of preoperative values were more than 5 ng/ml and 41% greater than 15 ng/ml. Only 6% reached diagnostic levels for malignancy (greater than 52ng/ml) and adenocarcinomas formed 47% (7 out of 15) of these. Sequential estimation in patients during and after treatment showed fluctuations which were related to disease status in 7 (32%) of 22 who have developed secondary disease. In three patients levels of greater than 50 ng/ml preceded clinical evidence of recurrence, and two patients have developed very high levels but have not yet developed other evidence of recurrent disease. It is concluded that raised CEA levels in lung cancer are infrequent, but in those patients who have or develop raised levels sequential investigation may be of value in monitoring response to treatment and clinical coourse.
41 ORAL ADMINISTRATION OF ANTI CD3-MONOCLONAL ANTIBODIES PROMOTES CD4+CD25+ LAP+ AND NKT LAP+ REGULATORY T LYMPHOCYTES AND AMELIORATES HEPATITIS BY INHIBITING CASPASE 3-MEDIATED APOPTOSIS
Authors: E. Orenbuch-Harroch, M. El-Haj, A. Ben Ya'acov, G. Lalazar, E. Zigmond, D. Kanovitch, Y. Ilan
Journal: Journal of Hepatology (2009)
Drug-Eluting Stents — Pushing the Envelope beyond the Labels?
Authors: Joseph P. Carrozza
Journal: New England Journal of Medicine (2008)

Unlike jurors, clinicians frequently must make decisions without the luxury of the totality of evidence. When we speak of evidence-based medicine, it is important to remember that available data may be incomplete, outdated, and of questionable relevance to particular patients, especially those excluded from randomized trials. Nowhere is this more apparent than in the controversies surrounding the use of drug-eluting stents in patients with coronary disease.Pivotal trials of drug-eluting stents reported significant reductions in the rate of repeat revascularization without excess adverse events in the first year after placement of the stent.1,2 Although these randomized trials were well . . .
A Longitudinal Study of Injury Morbidity in an African-American Population
Authors: Donald F. Schwarz
Journal: JAMA (1994)

<h3>Objective.</h3> —To improve understanding of the patterns of injury morbidity and mortality in an urban African-American population. <h3>Design.</h3> —Prospective survey of emergency department records for a geographically defined population from 1987 through 1990. <h3>Setting.</h3> —Eleven hospital emergency departments in Philadelphia, Pa. <h3>Participants.</h3> —The approximately 68000 people living in 17 census tracts in western Philadelphia. <h3>Results.</h3> —A total of 46260 injury events were identified in the survey (168.8 events per 1000 population annually). Half of the population made an emergency department visit for one or more injuries during the 4 years of study. There were 2796 hospital admissions (10.2/1000 population) and 403 deaths (1.5/1000 population) as a result of these injuries. Although in 1987 falls were the most frequent type of injury resulting in an emergency department visit, by 1989 the number of interpersonal intentional injury events exceeded the number of falls. Interpersonal intentional injuries accounted for 31.2% of hospital admissions and 42.7% of deaths. Of men 20 through 29 years old, 94.3% visited an emergency department at least once in the 4 years because of an injury, and 40.9% of men in this age group sought treatment for one or more interpersonal intentional injuries. The likelihood of future interpersonal intentional injury—related visits increased with the number of previous injuries of this type. <h3>Conclusions.</h3> —Interpersonal intentional injury occurs frequently in this population. More attention needs to be paid to prevention and intervention to reduce the toll of this violence. The high prevalence of injury in certain age strata may make general, population-based efforts for injury prevention more efficient than efforts targeted to subgroups. (<i>JAMA</i>. 1994;271:755-760)
Case 2-1962
Authors: Earle M. Chapman
Journal: New England Journal of Medicine (1962)

Presentation of CaseA sixty-year-old woman entered the hospital because of cough and dyspnea.Three weeks previously the patient began to have a nonproductive cough on deep breathing. Fatigue developed, and five days before admission she experienced the onset of exertional dyspnea, becoming short of breath for fifteen or twenty minutes after climbing a single flight of stairs. Because of these symptoms she spent the four days before entry in bed, where she was comfortable but dyspneic on the slightest exertion. No chest pain, orthopnea or peripheral edema occurred.A chronic eczematoid dermatitis that was aggravated by nervousness and fatigue . . .
Adult subacute mountain sickness—a syndrome of congestive heart failure in man at very high altitude
Authors: I.S. Anand, Y. Chandrashekhar, H.K. Bali, P.L. Wahi, S.K. Jindal, R.M. Malhotra, S.S. Chauhan, R.K. Bhandari
Journal: The Lancet (1990)
Effects of glyceryl trinitrate on functionally regressed newly developed collateral vessels in conscious dogs
Authors: M. FUJITA, D. P McKOWN, M. D McKOWN, D. FRANKLIN
Journal: Cardiovascular Research (1988)

The effects of glyceryl trinitrate on collateral blood flow and regional myocardial function during a 2 min coronary occlusion were evaluated in 10 conscious dogs with well developed collateral vessels. Collateral growth was promoted by brief, repeated, reversible coronary occlusions. After partial regression in collateral function a small dose of glyceryl trinitrate (5 micrograms.kg-1) was injected intravenously 1 min before coronary occlusion. After pretreatment with glyceryl trinitrate the collateral blood flow velocity (mean[SD]) increased from 3.0(0.9) to 4.4(1.4) cm.s-1 (p less than 0.05). After 2 min of occlusion the percentage systolic subendocardial segment shortening in the collateral dependent zone increased from 7.8(6.1) to 12.6(6.7)% (p less than 0.05). The blood flow debt repayment after release of the occlusion decreased from 122(41) to 68(34%) (p less than 0.05). Thus in conscious dogs with regressed newly developed collaterals a major component of the beneficial effects of glyceryl trinitrate on collateral circulation is dilatation of collateral vessels, as evidenced by a pronounced increase in collateral blood flow and myocardial function during a transient period of coronary occlusion.
Serum levels of large tenascin‐C variants, matrix metalloproteinase‐9, and tissue inhibitors of matrix metalloproteinases in concentric versus eccentric left ventricular hypertrophy
Authors: Marcus Franz, Alexander Berndt, Annelore Altendorf‐Hofmann, Nico Fiedler, Petra Richter, Julia Schumm, Michael Fritzenwanger, Hans Reiner Figulla, Bernhard R. Brehm
Journal: European Journal of Heart Failure (2009)
"CUTIS ANSERINUS," OR "GOOSE PIMPLES"
Authors: H. L. Baptist
Journal: JAMA (1941)

<h3>To the Editor:—</h3> May I be permitted to differ with Dr. Buck of Boston on the term "goose flesh," "goose bumps" or "goose pimples?" The time honored Latin for this condition is "cutis anserinus" which methinks should be translated "goose skin," not "flesh."
A disease-associated cellular immune response in type 1 diabetics to an immunodominant epitope of insulin
Authors: David G. Alleva, Paul D. Crowe, Liping Jin, William W. Kwok, Nicholas Ling, Michael Gottschalk, Paul J. Conlon, Peter A. Gottlieb, Amy L. Putnam, Amitabh Gaur
Journal: Journal of Clinical Investigation (2001)

The 9-23 amino acid region of the insulin B chain (B9-23) is a dominant epitope recognized by pathogenic T lymphocytes in nonobese diabetic mice, the animal model for type 1 diabetes. We describe herein similar (B9-23)-specific T-cell responses in peripheral lymphocytes obtained from patients with recent-onset type 1 diabetes and from prediabetic subjects at high risk for disease. Short-term T-cell lines generated from patient peripheral lymphocytes showed significant proliferative responses to (B9-23), whereas lymphocytes isolated from HLA and/or age-matched nondiabetic normal controls were unresponsive. Antibody-mediated blockade demonstrated that the response was HLA class II restricted. Use of the highly sensitive cytokine-detection ELISPOT assay revealed that these (B9-23)-specific cells were present in freshly isolated lymphocytes from only the type 1 diabetics and prediabetics and produced the proinflammatory cytokine IFN-gamma. This study is, to our knowledge, the first demonstration of a cellular response to the (B9-23) insulin epitope in human type 1 diabetes and suggests that the mouse and human diseases have strikingly similar autoantigenic targets, a feature that should facilitate development of antigen-based therapeutics.
Patients' physical disability may influence doctors' perceptions of suitability for risk assessment of CHD
Authors: M. Banks, G. Kitas
Journal: BMJ (1999)

EDITOR—Gardener et al have raised the issue of barriers to referral in patients with angina, pointing to cultural gaps and perceptions leading to diagnostic confusion and inequality of referral for coronary revascularisation.1 Addressing this issue is essential for meeting the Health of the Nation target to reduce cardiovascular deaths.

Patients' perceptions are only one of the factors that lead to referral barriers. Doctors' perceptions of patients' suitability can also have profound implications for referral patterns for risk assessment of coronary heart …
Topical Drug Innovation From 2000 Through 2014
Authors: Jessica R. Walter, Shuai Xu
Journal: JAMA Dermatology (2015)

larization was noted on the melasma lesions at baseline compared with perilesional skin using VISIA-CR RBX Red subsurface analysis and laser confocal microscopy.However, no decrease in vascularization was observed on the laser-treated side between the baseline and posttreatment visits.At the final visit, no changes in vascularization were noted between the 2 sides.No scarring or postinflammatory hyperpigmentation was noted.Discussion | Our results show that Kligman formula combination cream is more effective than the copper bromide laser for treating melasma.At the 6-month follow-up, no difference was observed between the 2 approaches and, in both cases, the MASI scores were similar to those observed before treatment.Neither procedure prevented relapse despite the use of sunscreen in all the patients.The lack of changes in vascularization observed via both RBX Red subsurface analysis and laser confocal microscopy between the topical cream-and laser-treated groups suggests that the copper bromide laser did not effectively target the vascular component of melasma.These results show that Kligman formula combination cream remains the most effective treatment for melasma and show the crucial need for prospective randomized studies with long-term follow-up, compared with Kligman formula combination cream, to confirm the effectiveness of any new approach in treating melasma.