tbuckley/cabot-search huggingface dataset:
Using an electrocautery strategy or recombinant follicle stimulating hormone to induce ovulation in polycystic ovary syndrome: randomised controlled trial
Authors: N. Bayram
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b> To compare the effectiveness of an electrocautery strategy with ovulation induction using recombinant follicle stimulating hormone in patients with polycystic ovary syndrome. <b>Design</b> Randomised controlled trial. <b>Setting</b> Secondary and tertiary hospitals in the Netherlands. <b>Participants</b> 168 patients with clomiphene citrate resistant polycystic ovary syndrome: 83 were allocated electrocautery and 85 were allocated recombinant follicle stimulating hormone. <b>Intervention</b> Laparoscopic electrocautery of the ovaries followed by clomiphene citrate and recombinant follicle stimulating hormone if anovulation persisted, or induction of ovulation with recombinant follicle stimulating hormone. <b>Main outcome measure</b> Ongoing pregnancy within 12 months. <b>Results</b>. The cumulative rate of ongoing pregnancy after recombinant follicle stimulating hormone was 67%. With only electrocautery it was 34%, which increased to 49% after clomiphene citrate was given. Subsequent recombinant follicle stimulating hormone increased the rate to 67% at 12 months (rate ratio 1.01, 95% confidence interval 0.81 to 1.24). No complications occurred from electrocautery with or without clomiphene citrate. Patients allocated to electrocautery had a significantly lower risk of multiple pregnancy (0.11, 0.01 to 0.86). <b>Conclusion</b> The ongoing pregnancy rate from ovulation induction with laparoscopic electrocautery followed by clomiphene citrate and recombinant follicle stimulating hormone if anovulation persisted, or recombinant follicle stimulating hormone, seems equivalent to ovulation induction with recombinant follicle stimulating hormone, but the former procedure carries a lower risk of multiple pregnancy.
Textbook of Child Neurology
Authors: Doris A. Trauner
Journal: JAMA (1986)

The latest edition of Dr Menkes' classic book is an up-to-date and comprehensive text that has incorporated recent information on a variety of topics. Disorders that have been recognized only in the past few years, such as Rett's syndrome and systemic carnitine deficiency, are included. The chapter on neurological manifestations of systemic disease is an important addition. It contains a discussion of long-term neurological complications associated with treatment of childhood leukemia, a topic that is most enlightening given the improved prognosis for survival. Similarly, in the section on tumors of the nervous system, there is a discussion of immediate and long-term effects of radiation therapy, an increasingly common area of concern as brain tumor therapy becomes more sophisticated and aggressive. The section on metabolic disorders is thorough and well written. Dr Menkes has made a complex topic easily understandable. The only minor disappointment is the lack of discussion about treatment
Milk in Typhoid Fever.
Authors: A. L. Benedict.
Journal: JAMA (1906)

Buffalo, N. Y., Nov. 17, 1906. <h3>To the Editor:</h3> —On page 1615 ofThe Journal, Nov. 17, 1906, Dr. W. F. Church says: "One author (Benedict) objects to milk on account of its constipating effects and at the same time complains of the excess of fat which tends to prevent constipation." I can not remember ever writing any such paragraph and, indeed, always try to avoid inconsistency in the same paragraph. Experience, not theory, teaches that milk usually is constipating unless it favors conditions of alimentary saprophytosis that cause diarrhea. Experience also teaches that the comparatively small proportion and minute emulsion of fat in milk does not have the opposite tendency in the practical sense. According to the indications of a case, one must necessarily be so inconsistent as to complain, now of the excess, now of the deficit, of any one ingredient of any single foodstuff. Dr. Church has
Press: Australian media raises alarm over meningitis
Authors: M. Sweet
Journal: BMJ (2002)

Awareness campaign linked to launch of new vaccine

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In recent months, the Australian media have bombarded their audiences with distressing stories and images of babies and young children who have died or been disfigured by meningococcal disease. Not surprisingly, this has alarmed parents, judging by reports from besieged hospital casualty departments, doctors' surgeries, and health department hotlines. Even some of the groups working to raise awareness of the disease believe that it has been overhyped. “People are panic stricken,” says Elizabeth Watling, general manager of theMeningitis Foundation, an Australian affiliate of the UK-based Meningitis Trust.

Many media reports have highlighted the increasing incidence of meningococcal disease—in 1995 about two cases were reported for every 100 000 people, compared with 3.5 cases per 100 000 in 2001. But they have often failed to note that the disease remains relatively rare in Australia, which, unlike some other countries, has not had an epidemic for many years. The endemic disease is, according to …

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Aedes albopictus, Yellow Fever, and the Americas
Authors: C. F. RAMOS FILHO
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 February 1987Aedes albopictus, Yellow Fever, and the AmericasC. F. RAMOS FILHO, M.D., M.SC.C. F. RAMOS FILHO, M.D., M.SC.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-2-333_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In his editorial (1), Dr. Monath expresses concern about the potential introduction of the Asian mosquito, Aedes albopictus, into Latin America. Unfortunately, this has already happened (2). This species was discovered last year in Brazil, and preliminary studies have found it to be disseminated in three states (Rio de Janeiro, Espírito Santo, and Minas Gerais) in a discontinuous distribution. Although in every instance so far A. albopictus has been found breeding near human dwellings, it was found in some semirural locations, making quite real Dr. Monath's concern about this vector obtaining a firm, sylvatic foothold.Dengue fever...References1. MONATH T. Aedes albopictus, an exotic mosquito vector in the United States [Editorial]. Ann Intern Med. 1986;105:449-51. LinkGoogle Scholar2. FORATTINI O. Aedes (Stegomya) albopictus (Skuse): identification in Brazil. Rev Saúde Pública. 1986;20:244-5. CrossrefMedlineGoogle Scholar3. OSANAITRAVASSOS DA ROSATANGAMARALPASSOSTAUIL CAARAP. Dengue outbreak in Boa Vista, Roraima: preliminary communication. Rev Inst Med Trop São Paulo. 1983;24:53-4. Google Scholar4. FRANCO O. [History of yellow fever in Brazil.] Rev Bras Malariol Doencas Trop. 1969;21:317-520. Google Scholar5. LIMA J. [Risk of urbanization of yellow fever in Brazil.] Cad Saúde Pública. 1985;1:377-84. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Hospital Universitário da Universidade Federal do Rio de Janeiro 21941 Rio de Janeiro Brazil PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1987Volume 106, Issue 2Page: 333-333KeywordsDengue feverFevers ePublished: 1 December 2008 Issue Published: 1 February 1987 PDF downloadLoading ...
Doctors' Stories: The Narrative Structure of Medical Knowledge
Authors: Steven H. Miles
Journal: JAMA (1991)

This marvelous study of how doctors retell patients' stories comes at a critical time in medical history. The clinical interview, which has long suffered from too little teaching and too little time, faces a new challenge as medical diagnosis and causation descend from the clinical encounter with manifestations of diseased organs to technical probes of the microengineering of cells. The maturing of biological science poses a critical (and neglected) challenge for the doctor-patient encounter. For, even as patients get more powerful answers to what ails them, these answers are less likely to be derived from or related to their own experience. "Doctor, I have a lump in my breast, is it serious?" yields to "Our routine scans have located cells with an abnormal metabolic pattern that, though imperceptible to you, require excision and radiation." As this crevasse opens in the meeting ground of the patient's experience and the physician's inquiry,
Biliary atresia in childhood.
Authors: A P Mowat, E R Howard
Journal: BMJ (1977)

weekly intervals, and reinforced the importance of treatment.The tablets were dispensed in a tin which contained 12 tablets more than required for each two weeks.A treatment period was designated as compliant if 80 % or more of the tablets had been removed.All tablet counts were made at the end of the trial.No patient defaulted from attendance and all the tablet containers were returned as requested.The tables show the number of times the 800% value was achieved.Adherence to therapy was marginally better with atenolol and with once-daily treatment, but the differences were not statistically significant by the X2 test.No patient consistently failed to comply but only one complied throughout all periods of the trial.Side effects to atenolol were inconspicuous and were not associated with periods of drug-defaulting.Despite our attempts we failed to reach our goal for con- sistent tablet-taking one-third of the time.Tablet counts are indeed likely to lead to an overestimate of compliance.
Fluorescence Nanoscopy of Platelets Resolves Platelet‐State Specific Storage, Release and Uptake of Proteins, Opening up Future Diagnostic Applications
Authors: Daniel Rönnlund, Yang Yang, Hans Blom, Gert Auer, Jerker Widengren
Journal: Advanced Healthcare Materials (2012)

Abstract Dysregulation of how platelets store, sequester and release specific proteins seems to be implicated in many disease states, including cancer. Dual‐color immunofluorescence stimulated emission depletion (STED) microscopy with 40 nm resolution is used to map pro‐angiogenic VEGF, anti‐angiogenic PF‐4 and fibrinogen in &gt;300 individual platelets. This reveals that these proteins are stored in a segmented, zonal manner within regional clusters, significantly smaller than the size of an α ‐granule. No colocalization between the different proteins is observed. Upon platelet activation by thrombin or ADP, the proteins undergo significant spatial rearrangements, including alterations in the size and number of the protein clusters, and specific for a certain protein and the type of activation induced. Following these observations, a simple assignment procedure is used to show that the three distinct states of platelets (non‐, ADP‐ and thrombin‐activated) can be identified based on the average size, number and peripheral localization profiles of the regional protein clusters within the platelets. Thus, high‐resolution spatial mapping of specific proteins is a useful procedure to detect and characterize deviations in the selective storage, release and uptake of these proteins in the platelets. Since these deviations seem to be specific for, and may even underlie, certain patophysiological states, these findings may have interesting diagnostic and therapeutic implications.
Two thirds of primary care trusts are cutting referrals, shows survey
Authors: H. Mooney
Journal: BMJ (2011)

Two thirds of primary care trusts in England are restricting referrals for treatments they judge to be non-urgent or of low clinical value, and one third have expanded the list of procedures they will no longer fund, a survey has shown.

The survey showed that 64% of primary care trusts have introduced policies that restrict “non-urgent,” “limited clinical value,” “low priority,” and “cosmetic” treatments.

An investigation by GP magazine found that some trusts hope to save over £1m (€1.1m; $1.6m) by restricting referrals from GPs.

GP surveyed 152 trusts. Of the 111 trusts that responded on treatment funding, 35% said …
Digital Computer Analysis of the Vectorcardiogram of the Newborn Infant
Authors: LORIN E. AINGER, Patrick J. Brignole, Bill R. Campbell
Journal: Circulation (1967)

Data derived from digital computer analysis of three corrected lead recordings for each of 13 term, normal newborn infants obtained on the first day of life are reported. The Frank, Schmitt SVEC-III, and McFee axial systems recorded the time sequence of ventricular depolarization force orientation in an almost identical manner. The following electrocardiographic measurements are reported for each of the three lead systems: heart rate, P-R interval, QRS and S-T intervals, planar and spatial mean P vectors, successive planar mean instantaneous QRS vectors, maximum QRS spatial vector, maximal rightward and leftward QRS spatial vectors, mean and maximum planar and spatial T vectors, and planar and spatial ventricular gradients. In general, vector quantities during this period of life are of lesser magnitude and more variable in orientation than for older infants and children. Although newborn infant ventricular depolarization forces for the majority are directed anteriorly, to the right, and inferiorly, posterior and superior orientation is not uncommon.
Revertant mosaicism: partial correction of a germ-line mutation in COL17A1 by a frame-restoring mutation
Authors: Thomas N. Darling, Carole Yee, Johann W. Bauer, Helmut Hintner, Kim B. Yancey
Journal: Journal of Clinical Investigation (1999)

Generalized atrophic benign epidermolysis bullosa is an autosomal recessive subepidermal blistering disease typified by null mutations in COL17A1. In 1 large kindred, affected individuals were homozygous for a 2-bp deletion in COL17A1, 4003delTC, which resulted in a downstream premature termination codon, nonsense-mediated mRNA decay, and abrogation of type XVII collagen synthesis. Interestingly, 1 of these patients, although phenotypically identical to her affected siblings, showed focal expression of type XVII collagen in epidermal basement membrane in a pattern suggestive of revertant mosaicism. When studies of randomly obtained epidermal, oromucosal, and peripheral blood cells failed to identify the genetic basis of this apparent mosaicism, microscopic subpopulations of potentially revertant epidermal cells (i.e., those overlying basement membrane containing type XVII collagen) were selectively isolated using laser capture microdissection. Analysis of DNA and RNA from these cells revealed a second mutation, 4080insGG, on 1 allele of COL17A1. This 2-bp insertion corrected the reading frame just proximal to the premature termination codon, countered nonsense-mediated mRNA decay, and allowed protein production by patient keratinocytes in vivo and in vitro. These studies elucidate the molecular basis of a novel form of revertant mosaicism in humans.
Pictorial fetal movement charts
Authors: M. Gannon
Journal: BMJ (1989)

the mean arterial pressure is reasonable.'Measurements of peripheral vascular resistance and cardiac output in our patients confirmed this relation.The diagnosis of electromechanical dissociation in these circumstances is therefore extremely difficult, and resuscitation should not be abandoned until meaningful haemodynamic data have been obtained.Cuff blood pressure is often meaningless in these circumstances, and resuscitation should not be abandoned with this as the sole criterion.I would also remind others of recent British studies that confirm that age alone is not a prognostic indicator for survival from cardiac arrest.4`It is the nature of the underlying rhythm that is of greatest importance.
The histamine test meal in the rat
Authors: L. S. Valberg, L. J. Witts
Journal: Gut (1961)

A histamine test meal is described for the estimation of the secretion of gastric acid and pepsin in the unanaesthetized intact rat. The stomach of the rat secreted pepsin and a small amount of acid in response to the test meal of hypertonic sucrose. Stimulation with histamine produced a pronounced rise in acid secretion but the output of pepsin remained unchanged. The increase in acid secretion was correlated in the individual rat with a rise in the volume of gastric secretion. Histamine phosphate in a dose of 50 mg./kg. body weight produced maximal stimulation of gastric acid secretion and was free from toxic effects. Choline chloride, in a dose of 126·5 mg./kg. body weight, had no effect on the volume of gastric secretion and it was ineffective as a stimulant of either acid or pepsin secretion.
Referral mismanagement systems
Authors: J. Dean
Journal: BMJ (2013)

Referral management systems are teams led by general practitioners that aim to improve the efficiency of referrals from primary care to specialists. But the evidence seems clear: they do not improve access; they increase costs; and they preferentially target high referrers, not the worryingly low ones.1

Referral rates to clinics can vary 10-fold between general practitioners working at the same practice. And it drives those of us who work in these clinics nuts. The rapid access chest pain assessment clinic that I help run has clear …
Degradation, metabolism and toxicity of synthetic pyrethroids.
Authors: J Miyamoto
Journal: Environmental Health Perspectives (1976)

Synthetic pyrethroidal compounds undergo biodegradation in mammals both oxidatively and hydrolytically, and depending on the type of compound, either of the pathways may predominate. Thus, (+) - or (+/-) -trans isomers of the chrysanthemumate ester of primary alcohols such as fenothrin, furamethrin, proparthrin, resmethrin, and tetramethrin (and possibly permethrin, too) are metabolized mainly through hydrolysis of the ester linkage, with subsequent oxidation and/or conjugation of the component alcohol and acid moieties. On the other hand, the corresponding (+)-cis enantiometers and chrysanthemumate of secondary alcohols like allethrin are resistant to hydrolytic attack, and biodegraded via oxidation at various sites of the molecule. These rapid metabolic degradations, together with the presumable incomplete absorption from the gastrointestinal tract, would generally contribute to the low acute toxicity of synthetic pyrethroids. These compounds are neither skin irritants nor skin sensitizers, and inhalation toxicity as well as dermal toxicity are fairly low. Neither is teratogenic in rats, mice, and/or rabbits or mutagenic on various bacterial strains. Subacute and chronic feeding of higher amounts of the compounds to rats invariably causes some histopathological changes in liver; however, these are neither indicative nor suggestive of tumorigenicity. Based on existing toxicological information, the present recommended use patterns might afford sufficient safety margin on human population. However, in extending usage to agricultural pest control, much more extensive investigations should be forthcoming from both chemical and biological aspects, since there is scant information on the fate of these pyrethroids in the environment. Also several of the compounds may be very toxic to certain kinds of fish and arthropods.
PNEUMOCYSTIS CARINII PNEUMONIA AND PENTAMIDINE ISETHIONATE TOXICITY
Authors: Michael Emmer, Vincent T. Devita
Journal: Annals of Internal Medicine (1968)

Letters and Comments1 September 1968PNEUMOCYSTIS CARINII PNEUMONIA AND PENTAMIDINE ISETHIONATE TOXICITYMICHAEL EMMER, M.D., VINCENT T. DEVITA, M.D.MICHAEL EMMER, M.D.Search for more papers by this author, VINCENT T. DEVITA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-69-3-637_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: Recently in the ANNALS (1) we reported the diagnosis and treatment of Pneumocystis carinii pneumonia in patients undergoing chemotherapy for malignancies. Two of the seven patients were treated with pentamidine isethionate with only a presumptive antemortem diagnosis; the diagnosis in each case, however, was confirmed at autopsy. Neither significant response to therapy nor toxicity was noted. We stressed the importance of pretreatment lung biopsy in evaluating effectiveness of this drug, since several other patients had been treated because of a similar presentation with recovery but without biopsy evidence of P. carinii pneumonia.This disease is occurring more...References1. VOGELCOHENPOWELLDEVITA CLMHRDVT: Pneumocystis carinii pneumonia. Ann. Intern. Med. 68: 97, 1968. LinkGoogle Scholar2. ROBBINSMILLERAREAUPEARSON JBRHVMHA: Successful treatment of Pneumocystis carinii pneumonitis in a patient with congenital hypogamma globulinemia. New Eng. J. Med. 272: 708, 1965. CrossrefMedlineGoogle Scholar3. SmithGaspar EIA: Pentamidine treatment of Pneumocystis carinii pneumonitis in an adult with lymphatic leukemia. Amer. J. Med. 44: 626, 1968. CrossrefMedlineGoogle Scholar4. MULLIGANBAUM WJGL: Diagnosis of pneumoncytosis (letters and comments). Ann. Intern. Med. 68: 1373, 1968. LinkGoogle Scholar5. WEINFREEMANSCOTHER RWNM: The metabolic effects produced by certain aromatic diamidines. Ann. Trop. Med. Parisit. 39: 19, 1943. CrossrefGoogle Scholar6. PAYETSANKALE MM: Transitory hyperazotemia during the treatment of human African trypangsomasis by diamidines. Bull. Soc. Path. Exot. 53: 690, 1960. Google Scholar7. RIFKINDFARISHILL DTDRB: Pneumocytis carinii pneumonia: studies on the diagnosis and treatment. Ann. Intern. Med. 65: 943, 1966. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPneumocystis Carinii Pneumonia: Review with a Case StudyPneumocystis Carinii Pneumonia Treated with PentamidineThe LeishmaniasesThe Diagnosis and Management of Pneumocystis carinii PneumoniaPENTAMIDINE NONTOXICITYKARL A. WESTERN, M.D., MYRON G. SCHULTZ, D.V.M., M.D., D.C.M.T. 1 September 1968Volume 69, Issue 3Page: 637-639KeywordsAutopsyBiopsyChemotherapyDrugsLungsPneumocystis carinii pneumoniaPneumoniaToxicity ePublished: 1 December 2008 Issue Published: 1 September 1968 PDF downloadLoading ...
Osteoclast-secreted CTHRC1 in the coupling of bone resorption to formation
Authors: Sunao Takeshita, Toshio Fumoto, Kazuhiko Matsuoka, Kyoung-ae Park, Hiroyuki Aburatani, Shigeaki Kato, Masako Ito, Kyoji Ikeda
Journal: Journal of Clinical Investigation (2013)

Bone remodeling is characterized by the sequential, local tethering of osteoclasts and osteoblasts and is key to the maintenance of bone integrity. While bone matrix-mobilized growth factors, such as TGF-β, are proposed to regulate remodeling, no in vivo evidence exists that an osteoclast-produced molecule serves as a coupling factor for bone resorption to formation. We found that CTHRC1, a protein secreted by mature bone-resorbing osteoclasts, targets stromal cells to stimulate osteogenesis. Cthrc1 expression was robustly induced when mature osteoclasts were placed on dentin or hydroxyapatite, and also by increasing extracellular calcium. Cthrc1 expression in bone increased in a high-turnover state (such as that induced by RANKL injections in vivo), but decreased in conditions associated with suppressed bone turnover (such as with aging and after alendronate treatment). Targeted deletion of Cthrc1 in mice eliminated Cthrc1 expression in bone, whereas its deficiency in osteoblasts did not exert any significant effect. Osteoclast-specific deletion of Cthrc1 resulted in osteopenia due to reduced bone formation and impaired the coupling process after resorption induced by RANKL injections, impairing bone mass recovery. These data demonstrate that CTHRC1 is an osteoclast-secreted coupling factor that regulates bone remodeling.