tbuckley/cabot-search huggingface dataset:
Can suicide be prevented?
Authors: D. Kamerow
Journal: BMJ (2012)

A new report from the US surgeon general lacks specificity and focus



Thirty years ago, my youngest sister, then 27 years old, jumped off a roof in New York and fell to her death. That anniversary and a new report from the US surgeon general have got me thinking about suicide prevention.

Suicide is a big public health problem. It is the 10th leading cause of death worldwide, accounting for about one million deaths a year.1 In the United States there were over 38 000 suicides in 2011.2 Men are 3-4 times as likely as women to kill themselves, though women attempt suicide much more often.

Risk factors for suicide have long been known. Psychiatric disorders are present in around 90% of people who kill themselves, and more than half of those who die by suicide meet criteria for a current depressive disorder. Other leading mental disorders associated with suicide include substance misuse, schizophrenia, and personality disorders. The problem, of course, is that while the vast majority of people who kill themselves have a mental disorder, only …
The safety of the Harmonic® FOCUS in open thyroidectomy: A prospective, randomized study comparing the Harmonic® FOCUS and traditional suture ligation (knot and tie) technique
Authors: Antonio Zanghì, Andrea Cavallaro, Maria Di Vita, Francesco Cardì, Paolo Di Mattia, Gaetano Piccolo, Giuseppina Barbera, Mario Urso, Alessandro Cappellani
Journal: International Journal of Surgery (2014)
Acute airway obstruction as a complication of untreated achalasia
Authors: J. Healy, J. Baillie
Journal: Endoscopy (2007)

A healthy 50-year-old white woman presented to the emergency department with acute-onset stridor and dyspnea. Although she had been diagnosed with achalasia 12 years earlier, she had declined therapy and had experienced minimal dysphagia. On arrival at the hospital, she was found to be cyanotic and bradycardic, and required emergency endotracheal intubation. She was extubated soon afterwards, but required nebulized racemic epinephrine because of persistent expiratory stridor. Computed tomography showed dilatation of the proximal cervical esophagus that did not impinge on the trachea ([Figure 1]). However, a more distal computed tomographic slice showed the esophagus to be severely dilated and compressing the posterior wall of the trachea ([Figure 2]). Upper endoscopy revealed a dilated esophagus with normal gastric and esophageal mucosa. After dilation of the lower esophageal sphincter with a 20-mm balloon, the patient felt dramatically better, with complete resolution of her stridor. She subsequently underwent an uncomplicated Heller myotomy with Dor fundoplication.
Preventing malaria in endemic areas
Authors: Donald R Roberts
Journal: BMJ (2007)

About 40% of the worlds population most of whom live in the poorest countries are at risk from malaria. In Africa alone malaria kills nearly a million children each year. Although we have the tools to fight malaria such as insecticides for indoor residual spraying environmentalist campaigns and some ill conceived decisions on public health policy have limited their use. A renewed effort is under way to control malaria in sub-Saharan Africa. While heartening the lead agencies have neglected to rebuild the technical expertise necessary to run effective vertical malaria control programmes. Still cautious of DDT (dichlorodiphe-nyltrichloroethane) and indoor residual spraying such programmes have focused on the distribution of bed nets impregnated with insecticides. In this weeks BMJ Hill and colleagues assess the effect of combining an insect repellent with insecticide treated bed nets on Plasmodium falciparum or P vivax malaria in Bolivia. The trial found that people who used treated nets and repellent had an 80% reduction in P vivax episodes compared with those who used treated nets alone (incidence rate ratio 0.2 95% confidence interval 0.11 to 0.38). The number of cases of P falciparum during the study was small and after adjustment for age a protective effect of 82% was seen although this was not significant (0.18 0.02 to 1.4). (excerpt)
Parkinson's disease as community health problem: study in Norwegian nursing homes. The Norwegian Study Group of Parkinson's Disease in the Elderly.
Authors: J P Larsen
Journal: BMJ (1991)

OBJECTIVE--To examine the extent of under-diagnosis and overdiagnosis of Parkinson9s disease and to determine quality of treatment in a defined population. DESIGN--Clinical evaluation of an elderly population. SETTING--40 Norwegian nursing homes. SUBJECTS--3322 residents of nursing homes, of whom 500 were selected by nursing staff for evaluation on the basis of a structured information programme on Parkinson9s disease and 269 were examined in detail by neurologists. MAIN OUTCOME MEASURES--Patients9 scores on clinical rating scales, diagnosis of parkinsonism, and effect of changing drug treatment. RESULTS--169 (5.1%) patients were found to have clinical idiopathic Parkinson9s disease, 31 of whom had not had the disease diagnosed previously. In addition, 31 patients without the disease were taking antiparkinsonian drugs unnecessarily. Eighty patients were judged to be receiving "optimal" treatment. In the remaining 58, the treatment was changed, and 36 patients showed a definite functional improvement after a 12 week observation period. CONCLUSIONS--The quality of life of many elderly patients with Parkinson9s disease could be improved by increasing medical and neurological services.
Non-NHS treatment centres are detrimental to local health services, finds BMA survey
Authors: Zosia Kmietowicz
Journal: BMJ (2006)

Independent sector treatment centres are much more likely than those run by the NHS to have a negative impact on the health facilities and services in their local areas, research commissioned by the BMA has found.

A survey of clinical directors working in orthopaedics, ophthalmology, and anaesthetics in NHS trusts in England found that 70% of respondents thought that treatment centres had helped to reduce waiting times and improve access for patients. But few thought that the centres had many other benefits if they were run by the independent sector rather than the NHS.

Only one in 20 respondents ranked the benefits of independent treatment centres as “substantial” compared with almost a …
Role of invading leukocytes in enhanced atrial eicosanoid production following rabbit left ventricular myocardial infarction.
Authors: M S Freed, P Needleman, C G Dunkel, J E Saffitz, A S Evers
Journal: Journal of Clinical Investigation (1989)

The isolated perfused hearts of rabbits previously subjected to in vivo left ventricular myocardial infarction (LVMI) show a 5-10-fold increase in f-Met-Leu-Phe (FMLP) and bradykinin (BK)-stimulated eicosanoid metabolite production relative to noninfarcted hearts. This exaggerated arachidonate metabolism has been shown to occur primarily in the cardiac atria, a site remote from the zone of injury and to be associated with a 10-15-fold increase in atrial FMLP receptor number in the absence of atrial inflammation. All of these changes were temporally related to leukocyte infiltration into the infarct zone. To determine whether invading leukocytes mediate these responses, acute inflammatory cell influx was suppressed either by inducing leukopenia with nitrogen mustard or by administration of BW-755C, a mixed cyclooxygenase-lipoxygenase inhibitor. Both pharmacological manipulations resulted in a decrease in inflammatory cells in the infarct zone and a marked suppression (50-70%) of ex vivo agonist-stimulated eicosanoid metabolite production from perfused hearts and isolated atria. These manipulations also resulted in reversal of ex vivo FMLP-induced coronary vasoconstriction as well as augmentation of BK-induced coronary vasodilation. Further studies in nitrogen mustard-treated animals revealed a suppression of the LVMI-stimulated increase in atrial FMLP receptor number. These data show that suppression of leukocyte invasion after LVMI attenuates enhanced cardiac and atrial eicosanoid metabolite production, and results in marked changes in coronary vascular reactivity. An additional finding was that basal and stimulated LTB4 production was markedly increased in infarcted hearts. In vivo suppression of the increase in LTB4 production by BW-755C was associated with inhibition of inflammatory cell influx into the infarct zone. It therefore appears that LTB4 may be an important proinflammatory mediator of leukocyte invasion after LVMI.
SC-20 * SUBVENTRICULAR ZONE INVOLVEMENT IN GLIOBLASTOMAS - DOES IT PREDICT AN ADVERSE OUTCOME?
Authors: A. Moiyadi, E. Sridhar, S. Kannan, T. Gupta, R. Jalali, P. Shetty
Journal: Neuro-Oncology (2014)

INTRODUCTION: Recently it has been shown that glioblastomas (GBM) arising in close proximity to known stem cell regions in the human brain have an aggressive behaviour and may confer an adverse outcome. Its implications on survival however remain unclear. METHODS: 104 consecutive GBMs were analysed in this study. Radiology was reviewed and tumor relationship to subventricular zone (SVZ) recorded. Routine clinical, surgical, and treatment details were recorded. Progression free and overall survivals were calculated. Univariate and multivariate analysis was performed to assses the role of known prognostic markers (age, KPS, RPA class, extent of resection ) as well as relation of the tumor to the SVZ. Various immunohistochemical markers were tested as surrogate markers for proliferation, invasive potential, angiogenesis, stemness, and lineage. RESULTS: Radiological (MRI) evaluation revealed involvement of SVZ in 64 (61.5%). Multifocality at presentation was present in 26 cases (25%) of which 20 belonged to the SVZ group (p = 0.06) . Gross total excision was achieved in 90% of those with no SVZ involvement versus 59% of those with SVZ involvement (p = 0.02). Median PFS and OS were 6.9 and 9.9 months respectively. On univariate analysis only RPA class, completion of radiotherapy and chemotherapy were significant for OS and PFS, the latter two being significant on multivariate analysis too. Though not statistically significant, tumors with SVZ involvement had poorer PFS and OS. CONCLUSION: Though SVZ involvement was not statistically significant, it showed a strong trend towards poor prognosis. It may preclude radical resection which can adversely impact the outcome. SVZ involvement can be a potential non-invasive prognostic marker.
Managing faecal incontinence
Authors: Robert J C Steele, Kenneth L Campbell
Journal: BMJ (2005)

Simple measures in primary care are often effective 

F aecal incontinence is a major problem. A recent systematic review of theliterature shows a prevalence of 11-15% in the community.1 These figures have to be interpreted with caution because the relevant studiesare hampered by possible under-reporting and, more importantly, by a lack of a consensus definition. Incontinence of flatus, liquid stool, or solid stool that has an impact on quality of life is a practical definition,2 and here we summarise the management of this heterogeneous condition mostly from a primary care perspective but including possible surgical interventions.

Faecal incontinence has many causes and varies in severity from minor faecal soiling to frank incontinence of solid stool. When a patient presents with this symptom we need to establish the degree of debility and obtain an obstetric history.3 Inspection of the anal canal and digital rectal examination is essential. Anal skin tags associated with haemorrhoids can hinder adequate toilet, and poor …
Doing What's Best for Patients: 1957 and 1997-Reply
Authors: Linda Emanuel
Journal: JAMA (1997)

<h3>In Reply.</h3> —Mr Kelly correctly notes the imperative to put health needs before professionals' self-interest. There is always the danger that this priority order is reversed; every professional and every professional organization must always be vigilant. This need for vigilance is what motivated the Sesquicentennial Conference, its theme, and its strong attendance. While Kelly is correct in noting that the Principles of Medical Ethics omit 2 important 1957 statements, he may have missed the Fundamental Elements of the Patient-Physician Relationship, reproduced below, which address the issues and without which the current Principles of Medical Ethics are not complete or properly read. Both are to be found in the volume that compiles the many ethics positions that together make up the current AMA<i>Code of Medical Ethics</i>.<sup>1</sup> The Fundamental Elements of the Patient-Physician Relationship: 1. The patient has the right to receive information from physicians and to discuss the benefits, risks, and
THE LIKENESS OF THE CORTICAL DYSRHYTHMIAS OF SCHIZOPHRENIA AND PSYCHOMOTOR EPILEPSY
Authors: F. A. Gibbs, E. L. Gibbs, W. G. Lennox
Journal: American Journal of Psychiatry (1938)

Available evidence indicates that the electro-encephalograph records the essential activity of the cortex of the brain, and the pattern of wave form is a constitutional characteristic of the individual. Therefore, abnormalities of rhythm may be of more fundamental significance than clinical manifestations. The three main manifestations of epilepsy (grand mal, petit mal and psychomotor epilepsy) are each accompanied by a distinct pattern of dysrhythmia. The electro-encephalogram record obtained in patients having psychomotor seizures is similar to that seen in most patients diagnosed as having schizophrenia. These records, furthermore, are closely similar to those obtained in the majority of children with psychopathic personalities. Schizophrenia and certain abnormal behavior may, like epilepsy, be spoken of as a form of cerebral dysrhythmia. On the basis of statistical, therapeutic and electrical evidence, we believe that any relationship between epilepsy and schizophrenia is positive rather than negative. We believe that some of the clinical boundary lines which delimit different disorders characterized by recurring psychic or psychomotor symptoms are artificial and are of secondary importance compared with classifications based on physiological pathology. Both normal and abnormal waves can be influenced by the experimental. This fact gives hope that chemical means may be found for controlling the abnormal rate regulating mechanism of the cerebral rhythms and thereby curing, or at least ameliorating certain disorders of the brain and mind.
Mass shootings on rise in US, says FBI report
Authors: M. McCarthy
Journal: BMJ (2014)

Mass shootings have risen markedly in the United States over the past 15 years, from an annual average of 6.4 a year between 2000 and 2006 to 16.4 a year between 2007 and 2013, says a new report by the US Federal Bureau of Investigation.1

“This trend reinforces the need to remain vigilant regarding prevention efforts and for law enforcement to aggressively train to better respond to—and help communities recover from—active shooter incidents,” the report said. “Active shooter incidents” are shootings during which there is time for either citizens or law enforcement personnel to intervene.

The purpose of the study was to …
Acute pancreatitis in systemic lupus erythematosus: report of a case unrelated to drug therapy.
Authors: R Wolman, C de Gara, D Isenberg
Journal: Annals of the Rheumatic Diseases (1988)

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease that can affect most organs or systems. It most frequently involves the joints, skin, and the kidneys. It less commonly involves the central nervous system, heart, and lungs. Acute pancreatitis in SLE is rare. It is usually mild, occurring in association with more severe organ involvement elsewhere. A patient with newly diagnosed SLE is reported who developed acute fulminant pancreatitis unrelated to concomitant drug therapy and who eventually died of complications including a systemic fungal infection related to this.
141 SERIAL MONITORING OF VIRAL LOAD AND SERUM ALANINE AMINOTRANFERASE LEVEL AND THE RISK OF HEPATOCELLULAR CARCINOMA (HCC): R.E.V.E.A.L.-HBV STUDY UPDATE
Authors: C.J. Chen, H.I. Yang, J. Su, C.L. Jen, S.L. You, C.F. Chen, U.H. Iloeje
Journal: Journal of Hepatology (2008)
Commentary: Supporting patient independence in long term haemodialysis
Authors: Tania Barnes, Michael Winfrow, Paul Laboi, Martin Wilkie
Journal: BMJ (2015)

Around 20 000 people in the UK are dependent on dialysis. It’s a demanding procedure, usually taking three to four hours, three times a week. Unsurprisingly, it disrupts people’s lives and can have a major effect on their wellbeing. Historically, there has been little opportunity for people to play an active part in managing their care, and patients often experience treatment as inflexible, demotivating, and disempowering.

We observed this in our dialysis unit and also saw people who we knew were capable of taking care of themselves. This led us to introduce a programme of shared care for haemodialysis patients across the Yorkshire and the Humber region in 2010, with support from the Health Foundation.

The programme is based on fostering a new partnership with patients and supporting them to take on components of their dialysis treatment. Patients choose which tasks they want to take on and the pace at which they do so. This allows them to be in control and build confidence over time. The programme adapts to a range of learning styles and …
Meta-analysis: Adjuvant tamoxifen reduces recurrence and death at 15 years in ER-positive early breast cancer
Authors: Belinda Kiely, Martin Stockler
Journal: Annals of Internal Medicine (2012)

Source Citation Early Breast Cancer Trialists' Collaborative Group, Davies C, Godwin J, Gray R, et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011;378:771-84. 21802721
Helicobacter pylori prevalences and risk factors among school beginners in a German urban center and its rural county.
Authors: O Herbarth, P Krumbiegel, G J Fritz, M Richter, U Schlink, D M Müller, T Richter
Journal: Environmental Health Perspectives (2001)

In 1998, the Helicobacter pylori [(13)C]urea breath test was offered to all school beginners (birth cohort 1991/1992) in the city of Leipzig and in Leipzig County, Germany, to determine the colonization prevalence and potential transmission pathways of the bacterium. A total of 3,347 school beginners participated in the test, and 2,888 parents completed the detailed, self-administered questionnaire. The H. pylori prevalence was 6.5% [95% confidence interval (CI), 5.3-7.6] in the city and 5.7% (CI, 4.2-7.0) in the county. Using cluster analysis (WARD's method, Euclidean distances), we identified different sets of variables (confirmed by multivariate logistic regression analyses [odds ratios (ORs)] that are signficantly associated with H. pylori positivity. Among city children, the risk is significantly increased with contact to a pet hamster (OR = 2.4; 95% CI, 1.2-4.7; p < 0.015) and travels to Asian countries (OR = 3.7; 95% CI, 1.6-8.7; p < 0.002). Among county children, H. pylori positivity increased significantly with drinking of water from nonmunicipal sources (OR = 16.4; 95% CI, 3.1-88.5; p < 0.001), more than 3 children living in a household (OR = 4.2; 95% CI, 1.2-14.6; p < 0.02), and contact with pet hamsters (OR = 2.4; 95% CI, 1.0-5.7; p < 0.04). These data suggest that, in a general population sample, indirect fecal-oral transmission and living conditions are important risk factors in the spread of H. pylori infection. However, clinical symptoms do not necessarily indicate H. pylori positivity.
GYNEMETRICS: A TERM TO DESIGNATE OBSTETRICS AND GYNECOLOGY
Authors: Carl T. Javert
Journal: JAMA (1946)

<h3>To the Editor:—</h3> Recently J. Pou Orfila, writing in<i>Obstetricia y ginecologia latino-americanas</i><b>2</b>:663 [Sept.] 1944, stated that obstetrics and gynecology should be combined as one specialty and designated by one word, namely gynecology. Orfila's plea for one word is not illogical, since the term obstetrics and gynecology is cumbersome. The thought comes to mind that a new word like "gynemetrics" may be more suitable when referring to the art and science of obstetrics and gynecology. The derivation is gyne (woman), metra (uterus) and ic (pertaining to), all from the Greek. An obstetrician and gynecologist could readily be designated as a "gynemetrician." A textbook of obstetrics and gynecology could be called a "Textbook of Gynemetrics." Greenhill's Year Book could be named the "Year Book of Gynemetrics." The gray journal could be named the "American Journal of Gynemetrics." Moreover, the terms "Ob" and "Gyn" might thereby be relegated to obscurity.
Pilonidal Cyst and Sinus
Authors: Joseph Liburt
Journal: New England Journal of Medicine (1948)

Primary Closure In this method, after the diseased tissue has been excised, the wound is closed by various types of suturing, in many cases in conjunction with gluteal flap placements, all aimed at effecting successful closure.Ferguson and Mecroy30 present 37 cases with 92 per cent cures following primary closure under a local anesthetic, an average healing time of seventeen and four-tenths days and two days lost from work.Cohn31 advocates complete excision with primary closure, using a series of U sutures on either side of the wound edges to include the sacrococcygeal fascia, and finally tying the sutures over . . .
ASSESSMENT OF LEFT VENTRICULAR DYSFUNCTION DURING RESTING ANGINA AND RESPONSE TO NITRATES BY PHASE ANALYIS OF RADIONUCLIDE ANGIOGRAPHY
Authors: Oberdan Parodi, Paolo Marzullo, Heinrich R. Schelbert, Antonio L??Abbate
Journal: Clinical Nuclear Medicine (1983)

Parodi, Oberdan; Marzullo, Paolo; Schelbert, Heinrich R.; L'Abbate, Antonio Author Information
ADRENOCORTICAL FUNCTION IN SCHIZOPHRENIA
Authors: EUGENE L. BLISS, CLAUDE J. MIGEON, C. H. HARDIN BRANCH, LEO T. SAMUELS
Journal: American Journal of Psychiatry (1955)

Adrenocortical function of chronic schizophrenics was investigated. The concentration of adrenal steroids (17-hydroxycorticosteroids) in the peripheral blood was determined at 8 am.; after the intravenous administration of various amounts of ACTH or of a pryogenic substance (Piromen); and after the subcutaneous injection of regular insulin. These drugs were employed to assess adrenocortical and pituitary-adrenocortical responsivity. Similar studies were made upon a comparable group of normal subjects. The adrenocortical and pituitary-adrenocortical reactivity of chronic schizophrenic and normal subjects were equivalent. There was no evidence of any impairment of adrenocortical physiology in the chronic schizophrenic patient.
Better surveillance and vaccine coverage are needed to eliminate measles in India by 2020
Authors: C. Travasso
Journal: BMJ (2015)

India will fail in its pledge to eliminate measles by 20201 without a better case based surveillance system, a steady availability of vaccines, high vaccine coverage, and extended laboratory facilities, an expert has said.

In 2011 measles claimed about 56 000 lives in India, accounting for a third of the global burden from the disease.2 At the 66th session of the World Health Organization Regional Committee for South East Asia in 2013 India was among the 11 member states that pledged to eliminate measles …