tbuckley/cabot-search huggingface dataset:
Sulphanilamide in Gonorrhoea
Authors: A. J. Cokkinis
Journal: BMJ (1937)

MEDICAIL JOURNALwere no premenstrual changes in the stoma.Injections were given for another six weeks, when menstruation was regular, the periods lasting four days.The uterine cavity measured.24 inches in length, and the body of the uterus was definitely larger on palpation.Following discontinuance of the injec- tions " periods" have continuLed spontaneously.It is now three mloniths since the last injection was given.Case 2.-A married woman aged 26.The periods started wlhen she was 15, and were of a twenty-day cycle with excessive loss until marriage.one y-ear befor-e she came to hospital.Since marriage the loss had markedly and progressively de- creased, lasting only one day and needing merely one pad.With injections the loss increased, the next period needing two pads; the following one lasted two days, four pads being used; the next, five pads; and the subsequient two, six pads.Injections were stopped and she has since had a four-day normal period spontaneoLusly.Case 3.-An unmarried girl aged 18, who complained of irreguLlar menstruation.The periods had started when she was 16. vears old, and had never been regular, the interval varying between three weeks and three months.The preViOuS period had been two months befor-e she came to hospital, and the preceding ones at three months' intervals.The uterus was ratlher small.There was no result from the injections until she had had twelve, when a period occurred.This might obviously have been her " normal " period.However, the next camiie at five weeks' interval, and injections were stopped.The following period was at four weeks' interval, and came on spontaiieously.Case 4.-A married woman aged 27.The menstrual history was that, following irregularity at the onset when 15, the periods had been regular until a few months previously.The periods then became a fortnight late, and finally there had been three months' amenorrhoea without pregnancy.The utieruLs was of normal size.Regularity was established with antostab.In this case the endometrium on section showed evidence of luteinization prior to the use of the antostab.Caise 5.-An unmarried woman,'aged 21.Amenorrhoea had persisted for one year, menstruation having started at 16 with some epimenorrhoea.Antostab was administered without avail, curettage showed very little endometrium in a resting
RELATIONSHIP BETWEEN QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY PARAMETER AND PRESSURE-DERIVED FRACTIONAL FLOW RESERVE FOR ASSESSING THE FUNCTIONAL SEVERITY OF CORONARY STENOSIS
Authors: Yasutsugu Shiono, Hironori Kitabata, Kohei Ishibashi, Kenichi Komukai, Takashi Tanimoto, Yasushi Ino, Hiroko Nakanishi, Keizo Kimura, Kumiko Hirata, Masato Mizukoshi, Toshio Imanishi, Takashi Akasaka
Journal: Journal of the American College of Cardiology (2011)
Your letter failed to win a place...
Authors: E. Shahar
Journal: BMJ (1997)

The quality of published scientific work is evaluated at least twice—by a handful of reviewers and editors during peer review and by an unknown number of readers after publication. Editorial peer review sometimes helps authors to improve their manuscripts, but more often it helps editors to decide between acceptance and rejection. Just as important—or perhaps even more important—are the unsolicited opinions of readers. Many of the readers are as qualified as the reviewers whose opinions contributed to the editorial decision.1 2

The voice of the reader is heard through letters written by the relatively few who formalise their critique in writing. Letters are sometimes better thought out than the original article. They may identify inaccuracies that were missed by formal peer review or uncover flaws in design, analysis, or interpretation. Peer review does not preclude error.1 Although letter columns are considered important by editorial boards,3 the fate of correspondence on published work is rarely determined by peer review. The editor(s) usually make the decision whether to publish, and rejection notes to authors are often standardised and contain little, if any, scientific explanation for the decision. Vague statements such as “in the face of fierce competition, your letter failed to win a place” or “many worthwhile contributions must be declined simply for lack of space” are typical.

The example I provide below illustrates the shortcomings of editorial practices. It is a “letter to the editor” (coauthored by Paul G McGovern) that was rejected with no specific explanation. Since the letter challenges unequivocally the main conclusion of an article, either the challenge or the original conclusion must …
Physiologic Principles in the Management of Dermatitis
Authors: Donald M. Pillsbury
Journal: New England Journal of Medicine (1951)

THE greatest single source of disability from skin diseases is the large group of acute and chronic dermatitic eruptions. These diseases, in spite of having certain basic features in common, may vary widely in appearance, and a great number of terms based on morphologic differences or etiologic factors have been applied to them. This multiplicity of terms has led to much confusion. A few of these terms are sufficiently informative and useful to justify their retention in medical nomenclature. In the case of many terms applied to dermatitic processes, however, the words are so complex or meaningless as to indicate . . .
Children in cars
Authors: I. Roberts, C. DiGuiseppi
Journal: BMJ (1997)

<h3>Background</h3> Thousands of people living in close proximity to gold mine waste dumps (GMWDs), are exposed to wind-swept, silica-rich dust. The effects on respiratory heath consequent on this exposure are largely unknown. <h3>Objective</h3> To examine associations between environmental GMWD dust exposure and respiratory health effects in adults. <h3>Methods</h3> This was a cross-sectional study of 93, 133 and 84 people in high (home &lt;500 m from GMWD), moderate (500 m-1km) and low (&gt;20 km) exposure groups respectively. We calculated a cumulative exposure index (CEI) based on exposure groups and years of residence. Participants were interviewed for respiratory symptoms, had chest X-rays (read by three experienced readers for tuberculosis and silicosis) and spirometry. We used multivariate logistic regression to examine the effect of dust exposure on respiratory health, and multiple linear regression to determine if CEI was associated with% predicted FEV1 and FVC. We adjusted for socioeconomic status, smoking and occupational and biomass fuel exposure. <h3>Results</h3> Being in the high exposure group versus the low was associated with elevated adjusted odds ratios (aORs) for upper respiratory (aOR: 2.76, 95% CI: 1.28–5.97) and ocular symptoms (aOR: 4.68; 95% CI: 1.87–11.68), chest wheezing (aOR: 3.78; 95% CI: 1.60–8.96) and spirometry-diagnosed COPD (aOR: 8.17; 95% CI: 1.01–65.85). We found similar associations for the high versus medium exposure groups, but no significant associations in the medium relative to the low group. Exposure had no significant effect on the risks of chronic bronchitis and tuberculosis. We found similar significant results for CEI as for the exposure groups analyses. On linear regression, CEI was not associated with% predicted FEV1, but, surprisingly, FVC was positively associated with CEI. No participant had radiological features of silicosis. <h3>Conclusion</h3> Residents residing &lt;500 m from GMWDs had elevated aORs for respiratory health effects. Both exposure measures (exposure groups and CEI) yielded similar results.
Anatomy of the Pancreatic Duct A Duodenoscopic-Radiological Study
Authors: M. Classen, H. Hellwig*, W. Rösch
Journal: Endoscopy (1973)

Diagnosis of pathological changes in endoscopic-radiological pancreatograms relies on the knowledge of normal anatomy of the pancreatic duct. For this purpose pictures of patients without pancreatic disorders were evaluated. The values are given in medians and decile ranges (i.e. 10–90%). The lenght of the pancreatic duct (n = 48) was calculated with a median x = 20.1 cm (decile range D.R. = 5.4 cm). Minor variations of the duct caliber seem to be normal. The values for maximal and minimar width in the three main segments of the pancreatic duct were: head: xmax. = 4.8 (D.R. = 2.3mm), xmin. = 3.4 (D.R. = 1.7 mm). Body: xmax. 3.5 (D.R. = 1.3 mm), xmin. = 2.7 (D.R. = 1.1 mm). Tail: xmax. 2.4 (D.R. = 0.9 mm), xmin. = 1.6 (D.R. = 0.9 mm). In addition the topography in correlation to the spine and the course of the pancreatic duct were studied. In 54% of the patients Vater's papilla was located in the middle third of the second portion of the duodenum.
A woman with periodic chest pain
Authors: A. J. Patel, R. Som, G. K. Soppa, E. E. J. Smith
Journal: BMJ (2012)

A 42 year old woman presented to the emergency department with a four hour history of central chest pain and breathlessness on exertion. She had been having similar chest pains on a periodic basis over the past year. Eight months before presentation, she had had a pneumothorax, which had not responded to chest aspiration or chest drain insertion, and had therefore undergone surgical pleurodesis. 

On examination her breath sounds at the right base were reduced, with a hyper-resonant percussion note. She appeared comfortable at rest, with a respiratory rate of 16 breaths/min. Her blood pressure was 110/50 mm Hg and her heart rate was 60 beats/min, in sinus rhythm. Chest radiography was performed.



### 1 If this were the patient’s first pneumothorax, how would you manage it acutely?

#### Short answer

For a first presentation of pneumothorax, if no underlying lung disease is evident clinically or radiologically, management depends on the size of the pneumothorax on chest radiography—if 2 cm or greater, needle aspiration should be attempted. If less than 2 cm, patients may be discharged with advice to seek urgent medical help if symptoms worsen. Patients should be followed up in two to four weeks in an outpatient setting.

#### Long answer

British Thoracic Society guidelines for spontaneous pneumothorax stipulate that primary spontaneous pneumothorax needs to be distinguished from secondary spontaneous pneumothorax to guide appropriate management.1 Secondary spontaneous pneumothorax occurs in the presence of underlying lung pathology. Active management is needed for all patients with pneumothorax who have severe …
Following the Water: A Controlled Study of Drinking Water Storage in Northern Coastal Ecuador
Authors: Karen Levy, Kara L. Nelson, Alan Hubbard, Joseph N.S. Eisenberg
Journal: Environmental Health Perspectives (2008)

To design the most appropriate interventions to improve water quality and supply, information is needed to assess water contamination in a variety of community settings, including those that rely primarily on unimproved surface sources of drinking water.We explored the role of initial source water conditions as well as household factors in determining household water quality, and how levels of contamination of drinking water change over time, in a rural setting in northern coastal Ecuador.We sampled source waters concurrently with water collection by household members and followed this water over time, comparing Escherichia coli and enterococci concentrations in water stored in households with water stored under controlled conditions.We observed significant natural attenuation of indicator organisms in control containers and significant, although less pronounced, reductions of indicators between the source of drinking water and its point of use through the third day of sampling. These reductions were followed by recontamination in approximately half of the households.Water quality improved after water was transferred from the source to household storage containers, but then declined because of recontamination in the home. Our experimental design allowed us to observe these dynamics by controlling for initial source water quality and following changes in water quality over time. These data, because of our controlled experimental design, may explain why recontamination has been reported in the literature as less prominent in areas or households with highly contaminated source waters. Our results also suggest that efforts to improve source water quality and sanitation remain important.
April May Be Cruel, but November's Pretty Lousy, Too
Authors: Eugenia L. Siegler
Journal: Annals of Internal Medicine (1996)

On Being a Doctor1 November 1996April May Be Cruel, but November's Pretty Lousy, TooEugenia L. Siegler, MDEugenia L. Siegler, MDBrooklyn Hospital Center, Brooklyn, NY 11201.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-9-199611010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A favorite story from my housestaff days at Bellevue Hospital is of the man who, dripping with lice, walked into the emergency department and announced, “My head feels funny.” His hemoglobin concentration turned out to be about 3.0 g/dL, but of course we did not find that out until after the nurses had “Kwelled” him. We found no gastrointestinal problems or other cause of the anemia; our diagnosis of exclusion was iron deficiency anemia due to chronic body lice infestation. I spent 4 years at Bellevue talking about lice, laughing about lice, and writing orders about lice, and yet I ... Author, Article, and Disclosure InformationAffiliations: Brooklyn Hospital Center, Brooklyn, NY 11201.Current Author Address: Eugenia L. Siegler, MD, Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySome lousy questions for home health nurses 1 November 1996Volume 125, Issue 9Page: 774-775KeywordsHead liceHemoglobinHumidityIron deficiency anemiaLearning curvesLiceNursesQuality of lifeQuarantinesResidency Issue Published: 1 November 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Endocarditis Due to Resistant Viridans Streptococci during Oral Penicillin Chemoprophylaxis
Authors: Joseph E. Parrillo, George C. Borst, Mark H. Mazur, Paul Iannini, Mark S. Klempner, Robert C. Moellering, Seth E. Anderson
Journal: New England Journal of Medicine (1979)

OPTIMAL management of patients with rheumatic heart disease or a previous bout of acute rheumatic fever includes the administration of prophylactic antibiotics to prevent pharyngeal infection with Group A streptococci.1 , 2 Several studies have shown that oral penicillin prophylaxis is associated with a high prevalence of penicillin-resistant bacteria in the gingival flora.3 4 5 6 7 8 9 An original concern was that continuous low-dose prophylaxis would result in a high incidence of endocarditis due to resistant organisms that would be difficult to cure. Follow-up studies of large numbers of patients taking prophylactic penicillin have found no increase in the incidence of endocarditis,10 and few cases of . . .
The effect of acute and chronic ethanol intake on hepatic glycerolipid biosynthesis in the hamster.
Authors: R G Lamb, C K Wood, H J Fallon
Journal: Journal of Clinical Investigation (1979)

The effect of acute and chronic ethanol intake on hepatic glycerolipid biosynthesis in the hamster was studied by in vivo and in vitro techniques. The results were compared with those from control hamsters receiving isocaloric amounts of glucose. Both chronic and acute ethanol intake elevated serum and hepatic triglyceride concentrations and induced a rapid rise in the capacity of neutral glycerolipid formation from sn[1,3-14C]glycerol-3-phosphate by hamster liver homogenate and microsomal fractions. Ethanol intake also produced a corresponding increase in the incorporation of [1,3-14C]glycerol into hepatic neutral glycerolipids by the intact animal. The ethanol-induced rise in the capacity of neutral glycerolipid production by liver as measured in vivo and in vitro correlated well with an increase in hepatic phosphatidate phosphohydrolase activity. Therefore, the rise in hepatic and serum triglyceride levels associated with ethanol intake may be explained in part by an increase in the activity of the enzyme.
Précis of<i>Behaviorism: A conceptual reconstruction</i>
Authors: G. E. Zuriff
Journal: Behavioral and Brain Sciences (1986)

Abstract The conceptual framework of behaviorism is reconstructed in a logical scheme rather than along chronological lines. The resulting reconstruction is faithful to the history of behaviorism and yet meets the contemporary challenges arising from cognitive science, psycholinguistics, and philosophy. In this reconstruction, the fundamental premise is that psychology is to be a natural science, and the major corollaries are that psychology is to be objective and empirical. To a great extent, the reconstruction of behaviorism is an elaboration of behaviorist views of what it is for a science to be objective and empirical. The reconstruction examines and evaluates behaviorist positions on observation and the rejection of introspection, the behavioral data language, theory construction, stimulus-response psychology, the organization of behavior, complex processes, agency, and the interpretation of mentalistic language. The resulting reconstruction shows behaviorism to be a pragmatic psychological version of positivism based on a behavioral epistemology.
Emotional disturbances of handicapped pre-school children and their families--attitudes to the child.
Authors: A Bentovim
Journal: BMJ (1972)

The late Donald Winnicott provocatively stated& that "there is no such thing as a baby."He meant that it was impossible to think of a baby in isolation without considering his en- vironment: his caretaker, his mother, "or at least a pram with someone's eyes and ears glued to it."It is also impossible to think of a pre-school child without thinking of his family.The philosophy which considered the child in isolation, allowed the 2-year-old blind or severely deaf child to be taken away from his family and placed in an institution or special school for early training, has now undergone a welcome change.Through an "at-risk" register and regular screening, the handicapped infant and child should be identified at the earliest possible time and treated within the community.2The family, and particularly the mother, is often used as the first therapist, with the support of the professional giving the appropriate information and teaching the necessary skills.Comprehensive assessment and co-operative support is essen- tial from the team of general practitioner, community physician, health-clinic doctor, paediatrician, health visitor, district nurse, and social worker.All these should be the aims in the development of a comprehensive Health Service.When a mother or her medical adviser senses that some- thing is wrong with the child, intervention should not have to wait until a final diagnosis is made.Deficits in locomotion, perception, or expression should be attacked and the in- dividual child's needs met for nurture, stimulation, and an early opportunity to fulfil his potential.
Examination for Hernia In Children
Authors: R. Bessemer
Journal: JAMA (1969)

To the Editor:—  I have developed a useful procedure, not published as a physical observation in standard textbooks.  Often mothers come in with a report of groin swelling, typical of inguinal hernias, but because the child cannot cooperate with straining or coughing, it is impossible to demonstrate the hernia in the office.  I have found the following procedure useful: the child is stripped nude, and stood up on the examining table (or held up, if it is a small infant), and the full surface of the hand is placed over the abdomen. The abdomen is pumped in and out with gentle, small, frequent strokes ( as in pumping up an air mattress), and the fluid is pumped down into the hernia sac. This maneuver, without fail, demonstrates the hernia to its fullest extent, the size being limited by the fullness of the sac. This pumping is so effective that I have
The prevalence of common skin conditions in Australian school students: 2. Atopic dermatitis
Authors: None MARKS, None KILKENNY, None PLUNKETT, None MERLIN
Journal: British Journal of Dermatology (1999)

The prevalence of atopic dermatitis (AD) was recorded following examination by dermatologists and dermatology registrars of a random sample of 2491 school students throughout the State of Victoria, Australia. The overall prevalence, based on clinical examination, was 16.3% (95% confidence interval, CI 14.1-18.5), being higher in girls (17.7%; 95% CI 15.0-20.4) than boys (14.8%; 95% CI 11.8-17.8). Using the U.K. Working Party Diagnostic Criteria for AD reduced the prevalence to 10.8% (95% CI 9.3-12.3) with the prevalence in girls 12.3% (95% CI 10.1-14.4) and in boys 9.2% (95% CI 7.1-11.4). The prevalence was highest in 4-6 year olds (18.7% on clinical examination, 11.5% using the U.K. Working Party Criteria), decreasing with increasing age to 11.6% on clinical examination (8. 6% on U.K. Working Party Criteria) among 16-18 year olds. Most of those with AD were classified as having mild disease (54.1%), with 32.1% classified as having minimal and 13.8% as having moderate to severe disease. Over 80% of those who reported on the questionnaire that they had dermatitis that was then confirmed on examination had been using one or more products to treat it. Nearly 90% of these products were classified as efficacious, with medical practitioners being the major source of advice for their use (77%). Pharmacists (8%), family/friends (6%) and others (9%), including beauticians and naturopaths, made up the remainder of the persons from whom those affected had sought advice about their treatment. These data, the first community-based prevalence data on AD published from Australia, confirm that the condition is common among those of school age. There is a need for AD to be included among those conditions that are discussed in health education lessons in schools.
Prediction Instruments and Clinical Judgment in Critical Care
Authors: Marc D. Silverstein
Journal: JAMA (1988)

The development and dissemination of powerful, effective, and costly technologies for monitoring and treating lifethreatening illness have resulted in the widespread availability of intensive care units (ICUs) in hospitals. Medical ICUs admit acutely ill patients, chronically ill patients with 'an exacerbation, and, on occasion, terminally ill patients for monitoring and supportive treatment. Patients, their families, physicians, government, and third-party payers have been concerned about the high mortality rates among critically ill patients, the functional outcomes of survivors of intensive care, the costs of care, and decision making for the critically ill.<sup>1</sup>1 Studies of patients in medical ICUs have indicated that the ICU patient population comprises two different groups: critically ill persons who receive intensive therapeutic interventions (eg, the patient with septic shock and multisystem organ failure) and persons with serious conditions who receive intensive monitoring and observation for life-threatening complications amenable to prompt intervention (eg, the patient with