tbuckley/cabot-search huggingface dataset:
Treatment of chronic hepatitis C genotype 1 patients at an academic center in europe involved in prospective, controlled trials: Is there a selection bias?
Authors: Sandra Beinhardt, Albert F. Staettermayer, Karoline Rutter, Judith Maresch, Thomas M. Scherzer, Petra Steindl–Munda, Harald Hofer, Peter Ferenci
Journal: Hepatology (2011)

Pegylated interferon-alpha2/ribavirin (peg-IFN/RBV) is the standard of care (SOC) for patients with chronic hepatitis C (CHC) infection. Currently, direct-acting antiviral agents (DAAs) are evaluated in clinical trials. The aim of this study was to compare baseline characteristics and sustained virologic response (SVR) rates in patients included in clinical trials to those receiving SOC. Medical records of all 503 treatment-naïve patients with CHC, genotype (GT) 1, referred over a 4-year period (January 2006-December 2009) were reviewed. Only 310 of 503 (62%) patients received antiviral therapy, 141 were enrolled in randomized, controlled trials ("study patients"; 101 in DAA studies), and 169 received SOC. At baseline, viral load and platelet count were higher and bilirubin was lower in study patients than in SOC patients. History of psychiatric disorders was more common in SOC patients (43 [25%] versus study patients with 18 [13%]; P < 0.01). Liver biopsy was obtained in 98% of study patients, but only in 59% of SOC patients. Twenty-nine (21%) and 40 (40%) study and SOC patients, respectively, had advanced fibrosis (F3/4; P = 0.001). By intent-to-treat analysis, SVR rates were higher in DAAs (64%; 95% confidence interval [CI]: 53.4-74.4) than in SOC patients (46%; 95% CI: 37.9-53.7; P < 0.01), but not different when calculated on a treated-per-protocol (TPP) basis. Interleukin (IL)28B GT was equally distributed in both cohorts. By chance, more patients treated with IFN/RBV had rs12979860 C/C-GT (up to 44%) than DAA-treated patients. If analyzed according to the IL28B polymorphism, TPP SVR rates did not reach statistically significant differences among study and SOC patients.Baseline characteristics slightly favored study patients, but IL28B GT and treatment adherence were the most important factors determining outcome. Thus, the applicability of the results of controlled studies has to be tested in a "real-world" setting.
Methane negative chemical ionization analysis of 1,3-dihydro-5-phenyl-1,4-benzodiazepin-2-ones.
Authors: W A Garland, B J Miwa
Journal: Environmental Health Perspectives (1980)

The methane negative chemical ionization (NCI) mass spectra of the medically important 1,3-dihydro-5-phenyl-1,4-benzodiazepin-2-ones generally consisted solely of M- and (M-H)- ions. Attempts to find the location of the H lost in the generation of the (M-H)- ion were unsuccessful, although many possibilities were eliminated. A Hammett correlation analysis of the relative sensitivities of a series of 7-substituted benzodiazepines suggested that the initial ionization takes place at the 4,5-imine bond. For certain benzodiazepines, the (M-H)- ion generated by methane NCI was 20 times more intense than the MH+ ion generated by methane positive chemical ionization (PCI). By using NCI, a sensitive and simple GC-MS assay for nordiazepam was developed that can quantitate this important metabolite of many of the clinically used benzodiazepines in the blood and brain of rats.
Population based intervention to change back pain beliefs and disability: three part evaluation
Authors: R. Buchbinder
Journal: BMJ (2001)

<b>Background:</b> Mucociliary clearance (MCC) results in an effective interaction between the mucus layer and the normal coordinated ciliary beating. In cystic fibrosis (CF), MCC is impaired due to dehydrated mucus, but recent data suggest that an abnormal ciliary beating may contribute to poor MCC in CF patients. However, results are controversial: in CF patients, ciliary beat frequency (CBF) might be either decreased, or increased, and ciliary dyskinesia might be increased, compared with healthy subjects. <b>Aims:</b> To compare ciliary function in CF patients and in healthy subjects. <b>Method:</b> Ciliated epithelial samples were obtained by nasal brushing from 4 non-transplanted patients with CF (range age: 4-23). Beating cilia were recorded using digital high-speed videomicroscopy at 37°C within 9 hours after brushing. Ciliary functional analysis (CFA) is assessed by CBF and the percentage of dyskinetic ciliary beat pattern (CBP) and is compared with our laboratory normal values, calculated on 14 healthy subjects (range age: 22-54). <b>Results:</b> There is no difference in CBF between CF patients and healthy subjects. However, ciliary dyskinesia is significantly higher in CF patients. <b>Conclusion:</b> This pilot study suggests that, unlike previous studies, CBF is normal in CF patients. However, our results suggest that an abnormal ciliary function might contribute to impaired MCC in CF patients, as shown by the higher dyskinetic CBP compared with healthy subjects. To evaluate if ciliary dyskinesia is primary or secondary to chronic inflammation, CFA will be repeated after air-liquid interface cell culture.
Augusta Dejerine-Klumpke
Authors: RICHARD SATRAN
Journal: Annals of Internal Medicine (1974)

Few physicians are aware that Klumpke palsy or lower brachial plexus palsy was named by a woman. Augusta Klumpke—born in San Francisco, educated in Europe, and later married to the French neurologist, Dejerine—was the first to describe and elucidate mechanisms of lower brachial plexus palsy. The work was accomplished when she was a medical student at the Faculty of Medicine in Paris. She experienced difficulties in gaining entrance to medical school, and later she struggled successfully to secure an externship and, ultimately, the first woman's internship in the hospitals of Paris. Her appointment was owing to female medical student activism, the responsivity of the Republican government that followed the Franco Prussian War, and her successful completion of the difficult written and public-oral examinations. Her achievement led to new opportunities for women in what had been a traditionally restrictive medical system.
Assessment of the longevity of the liver using a rat transplant model
Authors: Y Sakai, R Zhong, B Garcia, L Zhu, W J Wall
Journal: Hepatology (1997)

ABSTRACT To assess the longevity of the liver, arterialized, orthotopic liver grafts were performed using syngeneic male BN/BiRij rats. Young (5–month–old) livers were transplanted into 5–month–old recipients (group I, n = 27), and old (28–month–old) livers were transplanted into 5–month–old rats (group II, n = 28). Recipient survival after transplantation was similar in both groups. The average age of the livers at the time of death was 16.7 months in group I and 39.1 months in group II. Four of the livers in group II survived for more than 4 years (48.1 to 52.4 months). Early deaths (less than 1 year) after transplantation were most commonly caused by biliary obstruction and cholangitis in both groups. Late deaths (more than 1 year) after grafting were mainly from heart failure or tumors. None of the animals died of liver failure or liver disease. Weight gain in the rats, total serum protein levels, and alanine transaminase levels after transplantation did not differ significantly between the two groups. There was a trend for the histological features of aging of the liver—fibrosis, bile duct proliferation, and pigment deposition—to become more prevalent as the livers became very old (mean age, 46 months). Nevertheless, typical aging changes, as individual findings, were absent in nearly half of the oldest organs. The alterations in morphology had no apparent effect on the ability of the livers to sustain the lives of the recipients. The liver of the BN/BiRij rat was capable of surviving far beyond the maximum life span of BN/BiRij rats, and rats in general. It did not become diseased in the process.
Two incorrect assertions about study of hospital standardised mortality ratios in the West Midlands
Authors: M. A. Mohammed, R. J. Lilford
Journal: BMJ (2013)

The series of BMJ articles on hospital mortality statistics and Mid Staffordshire NHS Foundation Trust underscores the complex issues involved.1 2 3 Hawkes and Godlee make two key assertions about our work.

Firstly, that there was a conspiracy in the West Midlands to discredit hospital standardised mortality ratios (HSMRs)—this is fiction. The medical director of the West …
Nontreatment of Hip Fractures
Authors: Dennis E. Hyams
Journal: JAMA (1978)

<h3>To the Editor.—</h3> Lyon and Nevins advocate persuasively the "nontreatment" of hip fractures in senile patients (238:1175,1977). They realize clearly (as shown by the opening sentence of their discussion) that to withhold surgery deliberately in the management of fractured femoral necks in elderly patients is to fly in the face of the orthodox opinions of many specialists in orthopedics and in geriatric medicine, but they emphasize that their policy is based on an assessment of the severity of brain failure in their patients, relating this to the likelihood of successful mobilization of the patients. They point out the merits of their conservative approach—partly humanitarian, partly pragmatic, and partly economic. Such a policy calls for certain essential conditions: (1) the prognosis of the patients' chances of mobilization must be made with great care and be based on sufficient hard data; (2) good nursing care, of the standard described by the authors,
Role of the Emergency Unit in a Community Hospital
Authors: Louis Kunian
Journal: New England Journal of Medicine (1970)

Abstract Emergency-room visits in the United States increased from 18,000,000 in 1958 to 44,000,000 in 1968. Most community hospitals have thus far responded inadequately to this demand, in terms of space, equipment and professional staffing. The community hospital emergency unit must more completely fulfill its role of an effective round-the-clock medical facility. The physical layout of the emergency unit can be a crucial determinant in the efficient rendering of care. Ancillary services must be in close proximity and function as an integral part of the entire emergency unit. There is a growing need for full-time emergency physicians with specialized training for this role.
Quinquennial cervical smears: every woman's right and every general practitioner's responsibility.
Authors: P Standing, S Mercer
Journal: BMJ (1984)

Out of 558 women aged 16 to 64 who were registered with one general practitioner, 459 were eligible to be screened for cervical cancer. Even though the practice had been taking cervical smears for many years, they were predominantly from women under 35. Of the eligible women between 35 and 64, 111 (37%) had never had a smear. After short term intensive screening the uptake rates, defined by a smear done within the past five years, rose to 100% for women under 35, 94% for those aged 35 to 64, and 96% for all eligible women. Screening was rewarding both in its clinical yield and in the income generated by item of service payment. The success of screening was largely due to the participation of practice nurses in taking smears, and to a new method of recording smear results and claims for them. Some women, however, refused to have cervical smears.
The Long-Term Effects of a Peer-Led Sex Education Programme (RIPPLE): A Cluster Randomised Trial in Schools in England
Authors: Judith Stephenson, Vicki Strange, Elizabeth Allen, Andrew Copas, Anne Johnson, Chris Bonell, Abdel Babiker, Ann Oakley
Journal: PLoS Medicine (2008)

Background Peer-led sex education is widely believed to be an effective approach to reducing unsafe sex among young people, but reliable evidence from long-term studies is lacking. To assess the effectiveness of one form of school-based peer-led sex education in reducing unintended teenage pregnancy, we did a cluster (school) randomised trial with 7 y of follow-up. Methods and Findings Twenty-seven representative schools in England, with over 9,000 pupils aged 13–14 y at baseline, took part in the trial. Schools were randomised to either peer-led sex education (intervention) or to continue their usual teacher-led sex education (control). Peer educators, aged 16–17 y, were trained to deliver three 1-h classroom sessions of sex education to 13- to 14-y-old pupils from the same schools. The sessions used participatory learning methods designed to improve the younger pupils' skills in sexual communication and condom use and their knowledge about pregnancy, sexually transmitted infections (STIs), contraception, and local sexual health services. Main outcome measures were abortion and live births by age 20 y, determined by anonymised linkage of girls to routine (statutory) data. Assessment of these outcomes was blind to sex education allocation. The proportion of girls who had one or more abortions before age 20 y was the same in each arm (intervention, 5.0% [95% confidence interval (CI) 4.0%–6.3%]; control, 5.0% [95% CI 4.0%–6.4%]). The odds ratio (OR) adjusted for randomisation strata was 1.07 (95% CI 0.80–1.42, p = 0.64, intervention versus control). The proportion of girls with one or more live births by 20.5 y was 7.5% (95% CI 5.9%–9.6%) in the intervention arm and 10.6% (95% CI 6.8%–16.1%) in the control arm, adjusted OR 0.77 (0.51–1.15). Fewer girls in the peer-led arm self-reported a pregnancy by age 18 y (7.2% intervention versus 11.2% control, adjusted OR 0.62 [95% CI 0.42–0.91], weighted for non-response; response rate 61% intervention, 45% control). There were no significant differences for girls or boys in self-reported unprotected first sex, regretted or pressured sex, quality of current sexual relationship, diagnosed sexually transmitted diseases, or ability to identify local sexual health services. Conclusion Compared with conventional school sex education at age 13–14 y, this form of peer-led sex education was not associated with change in teenage abortions, but may have led to fewer teenage births and was popular with pupils. It merits consideration within broader teenage pregnancy prevention strategies. Trial registration: ISRCTN (ISRCTN94255362).
Simple problems please, and one at a time
Authors: Fiona Godlee
Journal: BMJ (2005)

Great is our desire as doctors to identify a single simple problem that has a single simple solution. This approach usefully fits the constraints of the 10 minute consultation, but its roots lie in Western medicine's biomedical model of disease. Doctors are still trained to diagnose single well defined disorders and to offer single targeted treatments. We prefer if possible to deal with one problem at a time.

The very name post traumatic stress disorder (PTSD) fits this picture: a single problem with an identifiable cause and potentially therefore a single solution. But this is deceptive …
Tampons and Toxic Shock Syndrome
Authors: Geoffrey Place
Journal: JAMA (1984)

<h3>To the Editor.—</h3> Procter &amp; Gamble takes strong exception to the MEDICAL NEWS article entitled "Holdup of Toxic Shock Data Ends During Trial in Texas." Any suggestion that Procter &amp; Gamble has attempted to suppress publication of scientific data about TSS is preposterous. At no time has Procter &amp; Gamble as a company or any Procter &amp; Gamble scientist attempted to inhibit any independent scientist from publishing data on TSS. Nor has Procter &amp; Gamble used the procedures of our judicial system to suppress publication of scientific information concerning TSS. Procter &amp; Gamble's TSS research agreements are written so that the decision to publish or not is strictly the responsibility of the investigator. We have separately providedThe Journalwith the research grant Procter &amp; Gamble has with the University of Wisconsin for support of Dr Bergdoll's research on TSS, which makes it clear that Dr Bergdoll's findings are his
Colleges say no to forced caesarean sections
Authors: C Dyer
Journal: BMJ (1994)

The Royal College of Obstetricians and Gynaecologists (RCOG) in Britain is to be asked this month to approve a paper by its ethics committee strongly opposing the use of the courts to sanction obstetric intervention against a patient's will. The committee takes the same line as the American Medical Association (AMA), which spoke out against the practice after a string of caesarean sections were ordered by courts in the US.

American courts have become more reluctant to make such orders since the District of Columbia Court of Appeals held in 1990 that women have a virtually absolute right to make choices about their health care, even when these endanger the life of …
Cancer and Extraversion
Authors: A. Coppen, M. Metcalfe
Journal: BMJ (1963)

tion.The incidence of pelvic recurrence after palliative excision operations was 25 %.After radical anterior resection about 7% of patients developed pelvic recurrence and 10 % after similar operations of a palliative nature.The incidence of pelvic recurrence after radical excision operations for tumours of the lower third of the rectum is 14.5%, for middle-third tumours 8.3%, and for upper-third tumours 5.2%.The particular liability of low rectal cancers to pelvic recurrence is explained by anatomical considerations which make adequate local excision difficult once growth has spread into the perirectal tissues.Among other factors specially influencing the develop- ment of pelvic recurrence after restorative or nonrestorative operations, whether radical or palliative, are tumours with lymphatic metastases, extensive local spread, and carcinomas of high-grade malignancy.It would appear from this study that little more can be done to prevent pelvic recurrence by conventional surgical methods alone.It is suggested that radiotherapy be given a trial as an adjuvant method of treatment.We wish to acknowledge the foresight of Mr. W. B. Gabriel, who founded the follow-up department at St. Mark's Hospital, without which this investigation would have been impossible.Our thanks are also due to the surgical staff of the hospital, Dr. I.
Magnetic Resonance Imaging and Cerebrospinal Fluid Shunt Valves
Authors: Michael Akbar, Christoph Stippich, Alfred Aschoff
Journal: New England Journal of Medicine (2005)

the successful use of imatinib in two well-established experimental models of progressive pulmonary arterial hypertension; this treatment resulted in virtually complete reversal of lung vascular remodeling, pulmonary hypertension, and right-sided heart hypertrophy. 5 We recognize the limitations of a single case report, but we believe that antiproliferative treatment with an antagonist to the platelet-derived growth factor receptor may be a promising new targeted therapy for pulmonary hypertension.Reversal of lung vascular remodeling rather than prolonged vasodilation is the concept underlying the use of imatinib in pulmonary hypertension.
Acceptor-suppressor T cell hybridoma with a receptor recognizing antigen-specific suppressor factor.
Authors: I Takei, T Sumida, M Taniguchi
Journal: The Journal of Experimental Medicine (1983)

An acceptor hybridoma with a receptor that recognizes the keyhole limpet hemocyanin (KLH)-specific suppressor T cell factor (KLH-TsF) was established after the fusion of C57BL/6 splenic T cells enriched with KLH-coated petri dishes. The cloned hybridoma (34S-281) could be specifically activated by stimulation with the conventional KLH-TsF or monoclonal KLH-TsF from three different hybridomas in the absence of the relevant antigen (KLH) and it started to produce another factor that suppresses the antibody response against DNP-KLH in a KLH-specific fashion. The KLH specificity of the TsF was required for activation. The new factor was found not to bind the KLH but to be absorbed with the KLH-TsF-producing hybridoma. It is thus strongly suggested that the acceptor site has a complementary structure (antiidiotype) for the KLH-TsF. Moreover, the idiotypic determinant on KLH-TsF was found to have a structure similar to that on some of the anti-KLH antibodies, since the acceptor hybridoma was specifically killed by the conventional anti-KLH antibodies and complement. Drawing on the above results, the idiotype-antiidiotype network in the conventional antigen system is discussed.
Aspirin in the Secondary Prevention of Cardiovascular Disease
Authors: Anand K. Parekh, James M. Galloway, Yuling Hong, Janet S. Wright
Journal: New England Journal of Medicine (2013)

In 2007–2008, antiplatelet medications were prescribed at only 46.9% of visits for patients with ischemic vascular disease. The evidence of the benefit of aspirin with respect to cardiovascular outcomes underscores the substantial opportunity before clinicians and patients.
Paraphenylene diamine, a contact allergen, induces oxidative stress in normal human keratinocytes in culture
Authors: M. PICAKDO, C. ZOMPETTA, M. CRANDINETTI, F. AMELIO, B. SANTUCCI, A. FAGGIONI, S. PASSI
Journal: British Journal of Dermatology (1996)

During the course of evaluating the interaction between allergens and keratinocytes in the pre-immunological phase of contact sensitization, we have studied the effects of paraphenylene diamine (pPD) on membrane lipid peroxidation and on intracellular antioxidant levels in cultured human keratinocytes. pPD is an aromatic amine which undergoes spontaneous oxidation in culture medium, generating short-lived free radical species including oxyradicals. Following exposure to non-toxic concentrations of pPD (0.5-10 micrograms/ml), we have evaluated the fatty acid pattern of membrane phospholipids as a target of peroxidative damage, and the intracellular level of reduced glutathione (GSH), the activity of superoxide dismutase (SOD), and that of catalase (CAT) as parameters of the antioxidant system. Depending on pPD concentration and the period of exposure, peroxidative damage with a significant decrease in membrane polyunsaturated fatty acids, was detected. Concentrations between 0.5 and 2 micrograms/ml produced an initial increase and then a decrease in both SOD and CAT activities, and in the oxidation of GSH, up to 12 h. After 24 h, when all the pPD had decomposed, recovery of the initial levels of the antioxidants was detected. Concentrations over 5 micrograms/ml induced a progressive decrease in both the enzymatic activities and the GSH concentrations. These results are consistent with the view that oxidative stress can be an essential event in the pre-immunological phase of contact sensitization.
Private doctors in India prescribe wrong tuberculosis drugs
Authors: G. Mudur
Journal: BMJ (1998)

Many private doctors in India are violating tuberculosis guidelines by giving their patients wrong combinations and inappropriate doses, a study has found. This may be a factor contributing to the rise of multidrug resistant tuberculosis in India.

The Indian health ministry's tuberculosis control programme detects 1.5 million new cases a year, but tuberculosis still kills around 1200 people each day. The study, conducted by a government tuberculosis centre in …