tbuckley/cabot-search huggingface dataset:
Hearing-Impaired Patients
Authors: Luther D. Robinson
Journal: JAMA (1977)

<h3>To the Editor. —</h3> It was good to see the article entitled "Medical Interpreting for Hearing-Impaired Patients" (237: 2397, 1977). The article brought into the open the difficulty deaf people have in receiving proper medical care because of the communication barrier. My own work in the field of medicalpsychiatric and mental health aspects of deafness covers a span of 14 years. During this time I have been aware that beyond the need for interpretive services, there is a need for qualified medical-psychiatric and mental health personnel to treat deaf patients who have such problems. Therefore, in the Mental Health Program for the Deaf, which I founded in 1963 at St Elizabeths Hospital, Washington, DC, personnel are trained to work with deaf people and their medical-psychiatric and mental health problems. In this connection, they are required to learn sign language and finger spelling to facilitate communication with deaf patients and deaf
[69] IDENTIFICATION OF FIBROBLAST GROWTH FACTOR RECEPTOR 2IIIB (FGFR2IIIB) AS TUMOR SUPPRESSOR IN HEPATOCANCEROGENESIS
Authors: T. Amann, T. Spruss, F. Bataille, C. Liedtke, M. Muhlbauer, C. Trautwein, A.K. Bosserhoff, C. Hellerbrand
Journal: Journal of Hepatology (2007)
Laparoscopy and laparotomy combined with bone marrow biopsy in staging Hodgkin's disease.
Authors: P Spinelli, G Beretta, E Bajetta, G Tancini, R Castellani, F Rilke, G Bonadonna
Journal: BMJ (1975)

The relative merits of laparoscopy with liver and spleen biopsy and staging laparotomy were studied in 91 unselected patients with Hodgkin9s disease. Laparoscopy with liver and spleen biopsy were combined with needle biopsy of the bone marrow and laparotomy was combined with open bone marrow biopsy. In 65 untreated patients six out of seven with liver or marrow disease, or both, were shown to have extranodal lymphomas in these sites by laparoscopy plus needle marrow biopsy. Among 26 patients who had been treated this finding occurred in six out of 10 patients. Spleen biopsies during laparoscopy detected infiltration by lymphoma in 14 out of 37 (38%) patients with diseases spleens. Morbidity was higher after laparotomy than after laparoscopy. Laparoscopy produced abdominal bleeding secondary to splenic biopsy in two patients. All patients with Hodgkin9s disease should be subjected to laparoscopy plus needle marrow biopsy before undergoing laparotomy.
HLA-DQ gene complementation and other histocompatibility relationships in man with the anti-Ro/SSA autoantibody response of systemic lupus erythematosus.
Authors: A Fujisaku, M B Frank, B Neas, M Reichlin, J B Harley
Journal: Journal of Clinical Investigation (1990)

A strong gene interaction between HLA-DQ1 and DQ2 alleles has been associated with anti-Ro/SSA autoantibodies (Harley, J.B., M. Reichlin, F. C. Arnett, E. L. Alexander, W. B. Bias, and T. T. Provost. 1986. Science [Wash. DC]. 232:1145-1147; Harley, J. B., A. S. Sestak, L. G. Willis, S. M. Fu, J. A. Hansen, and M. Reichlin. 1989. Arthritis Rheum. 32:826-836; Hamilton, R. G., J. B. Harley, W. B. Bias, M. Roebber, M. Reichlin, M. C. Hochberg, and F. C. Arnett. 1988. Arthritis Rheum. 31:496-505). To test a gene complementation mechanism for these results, restriction fragment length polymorphisms (RFLP) of the DQ alpha and DQ beta genes have been related to Ro/SSA precipitins in patients with systemic lupus erythematosus. In this study Ro/SSA precipitins are related to the simultaneous presence of a particular pair of RFLPs. A DQ alpha RFLP associated with HLA-DQ1 and a DQ beta RFLP associated with HLA-DQ2 predict that the alpha beta heterodimer in HLA-DQ1/DQ2 heteroxygotes is most closely related to anti-Ro/SSA autoantibodies, thereby supporting a gene complementation mechanism. Beyond this effect, an RFLP associated with HLA-DQ2 and/or DR7 is also related to Ro/SSA precipitins. Multiple molecular histocompatibility mechanisms are implicated, therefore, in the production of anti-Ro/SSA autoantibodies in autoimmune disease. For anti-Ro/SSA autoantibodies in SLE, and perhaps more generally, these data show that the histocompatibility antigens are among the elements that confer autoimmune response specificity and restrict the production of particular autoantibodies among patients with systemic lupus erythematosus.
Estimated glomerular filtration rate needs UK consensus
Authors: Annice Mukherjee, Donal O'Donaghue, Aram Redenski, John New, Patrick Twomey
Journal: BMJ (2006)

E DITOR—Chronic kidney disease imposes a substantial health burden, affecting 5% of the population. The renal national service framework recommends using the estimated glomerular filtration rate as a more sensitive marker for chronic kidney disease than serum creatinine. The quality and outcomes framework 2006-7 requires the estimated rate to achieve six points for a chronic kidney disease register and 21 points for measuring and treating blood pressure in chronic kidney …
Prognostic and management role of cardiovascular ultrasound in surgically treated aortic stenosis. A picture (with pressure) is worth a thousand inotropic agents.
Authors: R P Martin
Journal: Circulation (1992)

Cardiovascular ultrasound in the postoperative setting can be of value in helping to manage the patient who has undergone aortic valve replacement and is having a stormy postoperative course. Preoperative echocardiograms may not only detect the presence of those characteristics most likely to cause such a postoperative course but also select early postoperative pharmaceutical and volume interventions that are appropriate. It is hoped that the ability to preoperatively recognize those patients who are at high risk for developing intracavitary gradients will aid in appropriately managing them postoperatively and preventing the effects of prolonged hypotension secondary to intracavitary gradients. In addition, the early use of cardiovascular ultrasound in the postoperative patient to determine the functional and hemodynamic status of the ventricle, valvular structures, and pericardium may lead to appropriate early intervention, be it pharmacological or surgical, in patients who are having a complicated postoperative course.
Stat5b (Signal Transducer and Activator of Transcription 5b), Not Stat5a, Is a Critical Modulator of Human Treg Development and Function
Authors: J. Jenks, S. Seki, J. Huang, R. Nath, M. Madmedov, V. Hwa, R. Rosenfeld, K.C. Nadeau
Journal: Journal of Allergy and Clinical Immunology (2012)
Black-white differences in postprandial triglyceride response and postheparin lipoprotein lipase and hepatic triglyceride lipase among young men
Authors: Karen E. Friday, Sathanur R. Srinivasan, Abdalla Elkasabany, Caiping Dong, Wendy A. Wattigney, Edward Dalferes, Gerald S. Berenson
Journal: Metabolism (1999)
Surgery: A Concise Guide to Clinical Practice
Authors: A. P. Hovnanian
Journal: JAMA (1962)

The challenging problem confronting the 23 authors of this text undoubtedly is the choice of material, the extent of its discussion, and the reference list on the pertinent subjects discussed. Due consideration is given to the presentation of the subspecialties and the general surgical disease entities and to problems pertinent to their fields. The inclusion in the beginning of the text of the psychological problems encountered in surgical practice is worthy of notice. This is followed by a discussion of the medicolegal components as seen in the practice of surgery. It is heartening to note the importance given to the history and physical examination of the patient and the consideration given to the problems of pre- and postoperative management of the patient. Wound healing and biochemical changes in the body, as seen in surgical patients, are emphasized in the discussion. Certain typographical errors detract from the value of the text
Percutaneous endoscopic gastrostomy with the aid of a colonoscope to avoid gastrocolic fistula formation
Authors: K. Tominaga, Y. Saigusa, S. Ito, K. Hirahata, Y. Nemoto, I. Maetani
Journal: Endoscopy (2007)

Penetration of the colon and the subsequent development of a gastrocolic fistula is a recognized complication of percutaneous endoscopic gastrostomy (PEG) [1]. Normally the transverse colon is the only mobile portion of the colon lying anterior to the stomach, and so technical aspects aimed at minimizing such complications are mainly focused on the displacement of transverse colon that has become interposed between the stomach and the abdominal wall [2] [3] [4]. However, other segments of colon, such as sigmoid colon, may also become interposed between the stomach and the abdominal wall because of a lax mesentery and/or previous abdominal surgery.
Standards for Better Health: fit for purpose?
Authors: Charles D Shaw
Journal: BMJ (2004)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Standards for Better Health: fit for purpose? Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Africa on the Precipice: Perspective From South Africa-Reply
Authors: Michael Elmore-Meegan
Journal: JAMA (1994)

In Reply.  —Walker et al make some very helpful points. There are complex differences between evolving African countries. South Africa's mortality rate for children under 5 years of age is 72 per 1000 live births compared with 180 in least-developed countries and a mean of 101 in developing countries. 1 Forty-nine percent of South Africa's population is urbanized compared with a mean of 28% in sub-Saharan Africa, 1 while the maternal mortality rate stands at 83% in South Africa and 600 for sub-Saharan Africa. In most of Africa, 80% of the population remains rural. It is a tribute to the great advances in South Africa that it is so nonrepresentative of most of the continent.  Walker et al are, of course, correct that there must be a strengthening of health facilities and infrastructure; nor must we forget referral mechanisms and secondary care. A great failing of many donors and funding
Comparative sensitivity of exercise, cold pressor and ergonovine testing in provoking attacks of variant angina in patients with active disease.
Authors: D D Waters, J Szlachcic, R Bonan, D D Miller, F Dauwe, P Theroux
Journal: Circulation (1983)

Exercise, ergonovine and the cold pressor test have been used to provoke variant angina attacks. The sensitivity of these three tests was compared in 34 hospitalized patients with well documented, active variant angina who had recently undergone coronary arteriography. The three tests were usually performed on three consecutive days, and 28 of the 34 had the three tests within 1 week. Angina was provoked by ergonovine in all 34 patients, by exercise in 17 and by cold pressor test in only five (p less than 0.005). ST elevation developed during the ergonovine test in 32 (94%), during exercise in 10 (29%) and during the cold pressor test in only three (9%). With ergonovine, one patient had only ST depression and one had no ECG changes. During the cold pressor test two patients had pseudonormalization of abnormally negative T waves and 29 had no ECG changes. Exercise induced T-wave pseudonormalization in four patients, ST depression in nine others and no ECG changes in 11. ST elevation was more frequent with ergonovine than with either of the other tests (p less than 0.0001). ST elevation or T-wave pseudonormalization occurred more often with exercise than with cold (p less than 0.05), but both occurred less often than with ergonovine (p less than 0.0001). We conclude that the sensitivity of the ergonovine test is very high in patients with active variant angina and that exercise will provoke angina with ST elevation in about 30% of these cases. In contrast, the sensitivity of the cold pressor test is too low to be of much clinical value in the diagnosis of variant angina.
Treatment decision aids are unlikely to cut healthcare costs
Authors: S. J. Katz
Journal: BMJ (2014)

We should be asking broader questions about quality and effectiveness

The growing emphasis on patient centered care is increasing the demand on physicians’ time and effort to engage patients and their families in decision making regarding treatment. At the same time, the clinical encounter is becoming more challenging because evaluative testing strategies and decisions about disease management are increasingly complex.1 In this context, growing interest in decision aids is motivated by expectations that they can increase the efficiency and effectiveness of decision making regarding treatment and improve patients’ experiences. Indeed, there is compelling evidence that decision aids can increase a patient’s knowledge, satisfaction with the clinical encounter, and engagement with clinicians.2 More recently, decision aids have been advocated as a tool for dealing with the growing concerns about overtreatment and cost inflation.3 The argument is anchored on the assumption that a better informed and more engaged patient would be less likely to choose a management plan as extensive as that recommended by their clinician. The linked paper by Walsh and colleagues (doi:10.1136/bmj.g188) reviews the suggestion that decision aids could reduce costs,4 which has permeated policy statements and commentaries on both sides …
Health promotion in general practice
Authors: J. Muir, T. Lancaster, M. Thorogood, P. Yudkin, G. Fowler
Journal: BMJ (1994)

Authors' reply: Oxcheck study

EDITOR,--J K Cruickshank has misunderstood the design of the OXCHECK trial. As we stated, participants were randomised to the year of their health check before screening and intervention. We published data comparing the results of reexamination of the intervention group of subjects one year after their first health check with results obtained in a control group of subjects attending for their first health check in the year that the intervention group was re-examined; thus it was an unbiased analysis.

The design of the study was chosen for scientific validity, not because of restricted funding. Screening 2000 participants to provide control …
BENIGN TUMORS OF THE BREAST
Authors: HARRY C. SALTZSTEIN
Journal: JAMA (1949)

There are, perhaps, few conditions which cause as much anxiety and worry to the patient as do tumors of the breast. The reasons are not simple or clear. The breast is, of course, the most superficially placed of all organs where cancer frequently occurs, but there are deep psychogenic reasons which make the thought of loss of the breast terrifying to the average woman. Five years ago, in our personal practice, we operated on as many cancers of the breast as we did on benign lesions of the breast. For the past three years, our operative records show twice as many benign tumors as cancers. In addition, the number of breast conditions seen and not operated on now almost equals the number in which there was surgical intervention (table 1). We also noticed that the number of patients with breast conditions seemed to increase during and immediately after periods of
Evaluation of Phenoxypenicillins
Authors: G. M. Williamson, J. K. Morrison, P. G. D. Naylor
Journal: BMJ (1963)

MEDICAL JOURNA cases seen here suggest that a time- interval of weeks, or even months, may occur between the exanthem and the detection of frank thrombocytopenic purpura.It seems likely that, among virus infections.rubella may have a special importance in the causation of some cases of " idiopathic " thrombocytopenic par- pura, and, if this is so.its importance is surely belied at present by the scarcity of available information on the incidence of this serious complication.-Iam.etc.,
Pityriasis lichenoides: the differences between children and adults
Authors: S. Wahie, E. Hiscutt, S. Natarajan, A. Taylor
Journal: British Journal of Dermatology (2007)

Pityriasis lichenoides (PL) is a skin disease that affects both children and adults. Anecdotally, it is said to run a more benign course in children, with a frequent tendency to self-resolution. However, to our knowledge, there have been no published studies comparing PL in both age groups.To evaluate the clinicopathological features, overall efficacy of treatments and disease outcomes in children and adults diagnosed with PL.A retrospective review of records was undertaken on all patients diagnosed with PL at two regional centres during an 8-year period (from 1998 to 2006). For each individual, data were collected on age, sex, number of lesions, lesional morphology and distribution, symptoms, histopathological features, treatment modalities (and response), overall follow-up and length of remission.We recorded 25 children (median age 8 years, range 2-18) and 32 adults (median age 40 years, range 20-65) with PL. All the children and adults had more than 20 scaly, papular lesions. Children had greater lesional body involvement than adults. Lesions on the legs and trunk were present in 23 children (92%) compared with 19 adults (59%) (P < 0.01) and facial involvement was observed more commonly in children (n = 10, 40%) compared with adults (n = 8, 25%). Dyspigmentation was significantly more common in children (n = 18, 72%) compared with adults (n = 6, 19%) (P < 0.001). Topical corticosteroids were used by 16 children (64%) and 18 adults (56%) but only half in each group found these effective. Eight children (32%) were treated with erythromycin, with only two (25%) clearing, and one of these subsequently relapsing. In contrast, four adults (13%) received antibiotics, with three (75%) clearing and none relapsing thereafter. Ultraviolet B phototherapy was used in eight children (32%), with seven (88%) completely or almost clearing, but four (57%) subsequently relapsed. Fourteen adults (44%) received phototherapy; 10 (71%) completely cleared and only two of these (20%) subsequently relapsed. Strikingly, after a median disease duration of 30 months, only five children (20%) went into complete remission compared with 25 adults (78%) (P < 0.001).This is the first study to compare PL in children and adults. Our findings suggest that, compared with adults, PL in children is more likely to run an unremitting course, with greater lesional distribution, more dyspigmentation and a poorer response to conventional treatment modalities.
25-Hydroxyvitamin D <sub>3</sub> -1α-Hydroxylase Is Expressed in Human Vascular Smooth Muscle Cells and Is Upregulated by Parathyroid Hormone and Estrogenic Compounds
Authors: Dalia Somjen, Yosef Weisman, Fortune Kohen, Batya Gayer, Rona Limor, Orly Sharon, Niva Jaccard, Esther Knoll, Naftali Stern
Journal: Circulation (2005)

1,25(OH)2 vitamin D3 exerts multiple effects in human vascular smooth muscle cells (VSMCs). We therefore tested the possibility that VSMCs possess an endogenous 25-hydroxyvitamin D3-1alpha-hydroxylase system, the final enzyme in the biosynthetic pathway of 1,25(OH)2D3.We assessed the expression and activity of 25-hydroxyvitamin D3-1alpha-hydroxylase by real-time polymerase chain reaction and the conversion of 25(OH)D3 into 1,25(OH)2D3. First, 25-hydroxyvitamin D3-1alpha-hydroxylase mRNA was identified in cultured VSMCs by real-time polymerase chain reaction. Second, in cells treated daily (3 days) with parathyroid hormone (66 nmol/L), estradiol-17beta (30 nmol/L), raloxifene (3 micromol/L), and the phytoestrogens genistein (3 micromol/L), biochainin A (3 micromol/L), and 6-carboxy biochainin A (30 nmol/L), 25-hydroxyvitamin D3-1alpha-hydroxylase mRNA increased by 43+/-13%, (P<0.05) 7+/-24% (P=NS), 176+/-28% (P<0.01), 65+/-11% (P<0.05), 152+/-24% (P<0.01), and 71+/-9% (P<0.05), respectively. Third, production of 1,25(OH)2D3 from 25(OH)D3 was seen with a Km of 25 ng/mL and increased dose dependently after treatment with parathyroid hormone, genistein, and the phytosetrogen derivative 6-carboxy biochainin A. Estradiol-17beta and biochainin A also increased the generation of 1,25(OH)2D3 by 40+/-23% (P<0.05) and 55+/-13% (P<0.05), respectively.We provide here the first evidence for the expression of an enzymatically active 25(OH)D3-1alpha-hydroxylase system in human VSMCs, which can be upregulated by parathyroid hormone and estrogenic compounds. Because exogenous vitamin D inhibits VSMC proliferation, the role of this system as an autocrine mechanism to curb changes in VSMC proliferation and phenotype is a subject for future investigation.
Heterogeneous Hormonal Disorder in Pseudohypoparathyroidism
Authors: Stephen J. Marx, G. D. Aurbach
Journal: New England Journal of Medicine (1977)

Pseudohypoparathyroidism, as originally described by Fuller Albright and his associates,1 is a state of resistance to parathyroid hormone associated with characteristic somatic features such as short metacarpals, diminished height and rounded face. It was the first recognized human disease reflecting defective responsiveness to a hormone by otherwise normal target organs. Subsequently, states of diminished target responsiveness have been identified for many hormones. For some a cellular lesion has been established. For example, androgen resistance in testicular feminization may be associated with defective nuclear and cytoplasmic binding of dihydrotestosterone,2 and a syndrome of insulin resistance with acanthosis nigricans is caused by . . .
Medullary Suprarenal Chromaffinoma
Authors: D. Gutmann
Journal: BMJ (1947)

TUBERCULOUS PERICARDITISMEDICAL JOURNAL 3 that it may be insidious in its onset, transient in its course, and complete in its resolution.It is also suggested that in some cases it may be a late primary tuberculous manifestation and analogous to pleural effusion.The difficulty in proving the aetiology is stressed and the value of pneumopericardium in allowing the heart outline to be visualized is noted.Guinea-pigs inoculated with pericardial fluid may survive for many months before showing signs of disease, and much longer than the conventional six weeks is required before passing judgment.Gross pericardial thickening may develop in a relatively short space of time, and this relationship with Pick's disease is considered.All cases of pericardial effusion with a small heart and absence of rheumatic manifestations should be considered as potentially tuberculous unless proved otherwise.I should like to express my thanks to the physicians of St. George's Hospital for permission to publish these cases and for their helpful advice.
SMALLPOX AND VACCINATION, WITH SPECIAL REFERENCE TO GLYCERINATED LYMPH.
Authors: GEORGE DOCK
Journal: JAMA (1901)

For three years smallpox has existed in the United States to an extent not generally appreciated. The "Public Health Reports" of the Marine-Hospital Service give a total of 12,947 cases in various states and territories from June 28 to Oct. 25, 1901, and this is not a complete report for the whole country. In Michigan, according to Dr. H. B. Baker, there have been more than 3000 cases so far this year, while the prospect for the future is suggested by the fact that new foci are discovered at a rapidly increasing rate. Most of the cases have been mild, and this fact goes far to explain the great spread of the disease. It has often been so mild that it attracted little or no attention, or. if seen by a physician, was thought to be something other than smallpox; hence the numerous and often absurd names given, such as