tbuckley/cabot-search huggingface dataset:
Interface Between Basic Medical Sciences and Their Clinical Branches
Authors: William P. Longmire
Journal: JAMA (1964)

THE MISCIBLE substance on the interface of basic science and clinical medicine formed by previous generations of scientists and clinicians is what we call today "modern scientific medicine." Certain segments of knowledge that have been added to the fields of mathematics, physics, and chemistry and almost the total body of knowledge from the more closely related broad fields of anatomy, histology, physiology, bacteriology, and pathology provide most of the factual information from which we diagnose, treat, and prevent disease today. The clinician of today knows from the works of a previous era that the serum of blood normally contains a total of approximately 5 mEq of calcium and 2 mEq of inorganic phosphate per liter. He also knows that there are usually two pairs of parathyroid glands located close to the upper and lower poles on the posterior surface of the thyroid gland, and that they are about 5×5×3 mm
Ask every job candidate about care
Authors: C. Holcombe
Journal: BMJ (2015)

The NHS is a national treasure giving unparalleled healthcare at the point of need, regardless of patients’ ability to pay. Multiple injuries in a road traffic crash, an emergency caesarean section: the NHS is there. It is an organisation to which we have dedicated our lives, in which we often work above and beyond our contract and beyond what can reasonably be expected.

So why are so many of the stories in the news about failure, and particularly failure in care?

We are constantly bombarded by conflicting demands on our time and energy, and eventually we reach the limit of our capacity; …
Animal models for periodontal regeneration and peri‐implant responses
Authors: Alpdogan Kantarci, Hatice Hasturk, Thomas E. Van Dyke
Journal: Periodontology 2000 (2015)

Translation of experimental data to the clinical setting requires the safety and efficacy of such data to be confirmed in animal systems before application in humans. In dental research, the animal species used is dependent largely on the research question or on the disease model. Periodontal disease and, by analogy, peri-implant disease, are complex infections that result in a tissue-degrading inflammatory response. It is impossible to explore the complex pathogenesis of periodontitis or peri-implantitis using only reductionist in-vitro methods. Both the disease process and healing of the periodontal and peri-implant tissues can be studied in animals. Regeneration (after periodontal surgery), in response to various biologic materials with potential for tissue engineering, is a continuous process involving various types of tissue, including epithelia, connective tissues and alveolar bone. The same principles apply to peri-implant healing. Given the complexity of the biology, animal models are necessary and serve as the standard for successful translation of regenerative materials and dental implants to the clinical setting. Smaller species of animal are more convenient for disease-associated research, whereas larger animals are more appropriate for studies that target tissue healing as the anatomy of larger animals more closely resembles human dento-alveolar architecture. This review focuses on the animal models available for the study of regeneration in periodontal research and implantology; the advantages and disadvantages of each animal model; the interpretation of data acquired; and future perspectives of animal research, with a discussion of possible nonanimal alternatives. Power calculations in such studies are crucial in order to use a sample size that is large enough to generate statistically useful data, whilst, at the same time, small enough to prevent the unnecessary use of animals.
Agranulocytosis Secondary to Hydrochlorothiazide Therapy
Authors: Melvin B. Chrein
Journal: JAMA (1962)

SINCE THE INTRODUCTION of chlorothiazide and hydrochlorothiazide into the physician's armamentarium for the treatment of hypertension and as a valuable oral diuretic, many toxic reactions and side effects of the drugs have been reported. Clinical signs and symptoms of electrolyte imbalance, manifestations of skin photosensitivity, hypoglycemia and glycosuria, hyperuricemia, loss of libido, ammonia intoxication in cirrhotics, thrombocytopenia purpura, nausea, vomiting, diarrhea, dizziness, and paresthesias have been noted with "thiazide" therapy. It is the purpose of this paper to present a case report of a patient with agranulocytosis, apparently secondary to hydrochlorothiazide therapy. Agranulocytosis has previously been reported due to chlorothiazide. Report of a Case This was the second Montefiore Hospital admission of a 76-year-old widow who was admitted with a chief complaint of severe weakness of 1 to 2 weeks duration. The patient had a 3-year history of angina and dyspnea on exertion. She was admitted previously to this hospital
Spontaneous Uterine Rupture in Association with Abortion
Authors: M. D. Cameron, K. Chapman
Journal: BMJ (1963)

At the present time the treatment of established cancer involves the use of several specialized techniques.Surgery remains the treatment of choice when the disease is local, and for suspected local spread or recurrence radiotherapy is given.But when the disease is present in many parts of the body, or there are multiple lesions in one area, surgical removal or radiotherapeutic destruction of tumour is not always possible.It is reasonable then to investigate the possibilities of a drug which will reach both apparent and occult lesions.The drugs available at the present time fall into two broad groups-the hormones and cytotoxic drugs.Hormone therapy appears to change the environment in which the tumour cells lie so greatly that certain tumours cannot grow well and may even regress.However, even those " hormone-dependent " tumours eventually escape from control by environmental change.Cytotoxic drugs act by entering into the metabolism of tumour cells and so introducing a lethal abnormality in the cell.Division is usually prevented or the cells are destroyed before coming into division.Unfortunately these drugs do not go selectively to tumour cells, and this explains why they are so dangerous.They attack all dividing cells, but particularly rapidly dividing ones, such as bone-marrow, gastro-intestinal mucosa, foetal tissue, and skin.Again, tumour resistance eventually develops.
Clonal evolution in relapsed NPM1-mutated acute myeloid leukemia
Authors: Jan Krönke, Lars Bullinger, Veronica Teleanu, Florian Tschürtz, Verena I. Gaidzik, Michael W. M. Kühn, Frank G. Rücker, Karlheinz Holzmann, Peter Paschka, Silke Kapp-Schwörer, Daniela Späth, Thomas Kindler, Marcus Schittenhelm, Jürgen Krauter, Arnold Ganser, Gudrun Göhring, Brigitte Schlegelberger, Richard F. Schlenk, Hartmut Döhner, Konstanze Döhner
Journal: Blood (2013)
Finance and the Health Service
Authors: C. F. Mayne
Journal: BMJ (1974)

Married Women Consultants SnI,-In all the letters and discussion about 10-session contracts for consultants and whether or not private practice should be allowed I have seen no mention of maried women consultanir who, like my- self, elect to do maximum part-tmne work not to do private practice but so that they can have a modest amounit of
Assessment of Knowledge
Authors: L. A. Healy
Journal: JAMA (1971)

<h3>To the Editor.—</h3> In his guest editorial (<b>214</b>:1553,1970), Rosenow detects the illogic in assuming that compulsory attendance at postgraduate courses will ensure that patients receive the best quality of medical care. However, the program he espouses, whose stated aim is to<i>assess a knowledge</i>, is unlikely to do it either. The American College of Physicians' tests are constructed by academically oriented committees who derive material for questions from facts in medical journals. The first such test put much emphasis on less-common conditions that lend themselves to better test questions. It is a good test of knowledge, a poor assessment of practice. His final point is clearly wishful thinking. How could a voluntary self-assessment of knowledge which stresses confidentiality of results reassure anyone of clinical competence and "diminish the clamor" for measuring it? Quality of care can only be determined and demonstrated by auditing the care delivered.
Attitudes of doctors to the Alma Ata recommendations in Sri Lanka.
Authors: M A Varnam
Journal: BMJ (1986)

A detailed postal questionnaire was sent to 400 general practitioners, hospital doctors, and Ayurvedic practitioners in Sri Lanka as part of a wider study to investigate the delivery of primary medical care. The responses to questions that were related to the Alma Ata recommendations, which aim at providing "health for all by the year 2000," and the perceived health needs of the population are reported. Basic sanitation, clean water, adequate nutrition, and improved health education were considered to be the most important needs. When asked to suggest one change in health care 30% of the doctors recommended the integration of primary and secondary care services.
Exploiting tumor metabolism: challenges for clinical translation
Authors: Matthew G. Vander Heiden
Journal: Journal of Clinical Investigation (2013)

The metabolism of cancer cells differs from most normal cells, but how to exploit this difference for patient benefit is incompletely understood. Cancer cells require altered metabolism to efficiently incorporate nutrients into biomass and support abnormal proliferation. In addition, the survival of tumor cells outside of a normal tissue context requires adaptation of metabolism to different microenvironments. Some existing chemotherapies target metabolic enzymes, and there is a resurgent interest in developing new cancer drugs that interfere with metabolism. Success with this approach depends on understanding why specific metabolic pathways are important for cancer cells, determining how best to select patients, and developing technologies for monitoring patient response to therapies that target metabolic enzymes. The articles in this Review series address these issues, with a focus on how altered metabolism might influence tumor progression and how this knowledge might inform the use of new therapies targeting cancer metabolism. Emerging biomarker strategies to guide drug development are also highlighted.
A trial of clarithromycin for the treatment of suboptimally controlled asthma
Authors: E. Rand Sutherland, Tonya S. King, Nikolina Icitovic, Bill T. Ameredes, Eugene Bleecker, Homer A. Boushey, William J. Calhoun, Mario Castro, Reuben M. Cherniack, Vernon M. Chinchilli, Timothy J. Craig, Loren Denlinger, Emily A. DiMango, John V. Fahy, Elliot Israel, Nizar Jarjour, Monica Kraft, Stephen C. Lazarus, Robert F. Lemanske, Stephen P. Peters, Joe Ramsdell, Christine A. Sorkness, Stanley J. Szefler, Michael J. Walter, Stephen I. Wasserman, Michael E. Wechsler, Hong Wei Chu, Richard J. Martin
Journal: Journal of Allergy and Clinical Immunology (2010)
Vital Staining in Fiberoptic Bronchoscopy
Authors: F. Varoli, C. Mariani, A. Fascianella, F. Cosentino, G.C. Roviaro
Journal: Endoscopy (1986)

The authors report on the results obtained using vital staining in fiberoptic bronchoscopic investigations. Vital staining is performed during normal fiberoptic bronchoscopic investigations under local anesthesia. The method has proved very sensitive for cancerous and precancerous lesions of the bronchial mucosa.
Dermal in vitro penetration of methiocarb, paclobutrazol, and pirimicarb: effect of nonylphenolethoxylate and protective gloves.
Authors: J B Nielsen, H R Andersen
Journal: Environmental Health Perspectives (2001)

Dermal exposure has become the major route of human occupational exposure to pesticides. Detergents are used as part of formulated pesticide products and are known to change the barrier properties of human skin in vitro. However, studies on the influence of detergents as well as protective glove materials on dermal penetration of pesticides are scarce. In an experiment using in vitro static diffusion cells mounted with human skin, we evaluated the effect of nonylphenol-ethoxylate on dermal penetration of three extensively used pesticides--methiocarb, paclobutrazol, and pirimicarb--and the protection against dermal penetration offered by protective gloves made of latex or nitrile. There was a general tendency, though not statistically significant for all pesticides, for nonylphenolethoxylate to decrease the percutaneous penetration of the three pesticides. The nitrile generally offered better protection against percutaneous penetration of pesticides than did latex, but the degree of protection decreased over time and depended on the pesticides used.
Hepatitis-associated antigen in V.D. clinic patients.
Authors: G Papaevangelou
Journal: BMJ (1973)

histological picture was characterized by a massive, almost syncytial growth of reticulum cells with many Reed-Stemnberg cells, severe lymphocyte depletion, and albsence of eosinophils, plasma cells, or fiibrinoid necrosis.This picture was completely differ- ent from the entity described as Hodgkin's sarcoma.Deelmant and I concluded that this disease could be described, both on clinical and on pathological grounds, as a separate entity.I had the opportunity to discuss these cases personally in 1955 with both Dr.F. Parker and Dr. R. J. Lukes, who were at that time rather sceptical about my pro- posal to mark off this disease from classic Hodgkin's disease as a separate subgroup.However, it should be borne in mind that in 1955 discussions about the immunological nature of Hodgkin's disease were still un- heard of.A good account of identical cases had already been given in 1953 by Miss
Campaigners step up fight to "kill off" commissioning regulations
Authors: G. Iacobucci
Journal: BMJ (2013)

Opponents of controversial regulations that will require large sections of the NHS to be tendered to the open marketplace have stepped up their fight to “kill off” the proposals, ahead of a crunch parliamentary debate and vote later this month.

The regulations, which critics say will lead to widespread privatisation and fragmentation of the NHS, will be subject to a debate and vote in the House of Lords1 on 24 April, following a “fatal motion” laid down by Philip Hunt, deputy leader of the opposition in the House of Lords.

Ahead of the key debate, the website …
STUDIES ON THE OXIDATION AND REDUCTION OF IMMUNOLOGICAL SUBSTANCES
Authors: James M. Neill, William L. Fleming
Journal: The Journal of Experimental Medicine (1927)

The methods previously employed in the study of hemotoxins have been applied in the present investigation to the oxidation and reduction of the bacteriolytic substance of Pneumococcus. It is shown that the bacteriolytic agent, previously inactivated by oxidation, can be "reactivated" by treatment with bacterial reducing agents. Evidence is presented that this "reactivation" represents the reduction of inactive, reversible oxidation products to the original active substance. The bacteriolytic agent is an integral constituent of the pneumococcus cell, which can be separated from the hemotoxin by absorption with red blood cells in the cold.
Prognostic Value of Ballistocardiograms
Authors: Isaac Starr
Journal: JAMA (1964)

In any long-term study the doctor's experience is biased. The patients whom he sees are no fair sample of the sick population and those followed are biased by an overload of persons not doing well, who keep returning to him. So the percentage description of the medical experience, for many years the standard method of analyzing it, does not yield as valid information as has been generally believed. In this study, escape from these biases was sought by pairing the data and the method used could be applied to any medical experience. Two hundred twenty-one patients were followed for five years or longer after a high frequency force ballistocardiogram. After interfering factors had been eliminated, marked abnormalities of ballistocardiographic form were still associated with great reduction in longevity.
Electrosurgical Hazards In Laparoscopy
Authors: Richard M. Soderstrom
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Dr. Gordon R. Neufeld et al (226:1465, 1973) specifically blamed the Richard Wolf Instrument Corporation for defective equipment. I would like to take issue with their comments and suggest appropriate alternatives. My experience with Wolf laparoscopy equipment exceeds 2,000 laparoscopies in which no electrical burn has occurred due to defective equipment. Though it is true defective equipment can cause electrical burns when spark-gap (Bovie) cautery is used, the usual cause of defective equipment is improper care of laparoscopy equipment. We have a specific team of surgical personnel who inspect and maintain the laparoscopy equipment so that insulation breakdown does not occur. Burns to the patient and to the operator are usually due to improper laparoscopy technique such as applying electrical current with the electrode too close to the tip of the laparoscope. The real answer, however, to preventing electrical burns of the nature described by Dr. Neufeld
A Case of Cholestasis: Benign and Recurrent and Not due to Measles
Authors: C. Buffet
Journal: JAMA (1989)

To the Editor.—  In 1983 we reported in JAMA the case of a 19-year-old man who had a well-documented measles infection and cholestasis. 1 Jaundice appeared a few days after clinical symptoms of rubella. His total bilirubin level increased to 740 μmol/L, while his serum γ-glutamyltransferase level was normal. Endoscopic retrograde cholangiography showed normal biliary ducts. The usual causes of intrahepatic cholestasis were excluded. Histological study of the liver showed major centrolobular cholestasis without necrosis. Jaundice continued for 4 months, but 5 months after the onset results of liver function tests were normal.  Rubella seemed to have been the most likely explanation for the cholestasis. This case had a few points in common with that reported by McLellan and Gleiner. 2   Our patient remained in good condition until September 3, 1988, when he developed a pharyngitis. He received 1500 mg/d of troleandomycin. Two days later, troleandomycin therapy was discontinued because
Violence and Epilepsy
Authors: James A. Lewis
Journal: JAMA (1975)

THROUGHOUT history, epilepsy has been the victim of bad press. In ancient Greece, it was sometimes called the Herculean disease because Hercules was thought to have murdered his family in a fit of uncontrollable rage. Two thousand years later, Michael Crichton wrote in<i>The Terminal Man</i>, "Epileptics are predisposed to violent, aggressive behavior during their attacks." In later editions of his novel, Crichton softened his stance with a postscript, but many physicians and laymen still retain a belief that epileptics are dangerous, potentially violent people. In fact, the threads linking violence and epilepsy are tenuous and tangled. Epilepsy is one of the most common of neurological complaints. Epidemiological studies have placed prevalence at 0.5%, and there is good reason to suspect that this is an underestimation. In a recent publication of the National Institute for Neurological Diseases and Stroke, the figure 2% is cited. Since epilepsy appears early, lasts long,
Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial
Authors: R. S Hinman
Journal: BMJ (2003)

<h3>Abstract</h3> <b>Objectives</b> To test the hypotheses that therapeutic taping of the knee improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment. <b>Design</b> Randomised single blind controlled trial with three intervention arms (therapeutic tape, control tape, and no tape) of three weeks9 duration and three week follow up. <b>Setting</b> Outcome assessment was performed in a university based laboratory. Taping interventions were applied by eight physiotherapists in metropolitan private practice. <b>Participants</b> 87 patients with symptoms of knee osteoarthritis as defined by the American College of Rheumatology. <b>Main outcome measures</b> Primary outcome measure was pain as measured by visual analogue scale and participant perceived rating of change. Secondary measures of pain and disability included the Western Ontario and MacMaster Universities osteoarthritis index, knee pain scale, and the SF-36. <b>Results</b> The therapeutic tape group reported a greater reduction in pain on all primary outcomes than either of the other two groups. A significant association was evident between intervention and change in pain at three weeks (P=0.000), with 73% (21/29) of the therapeutic tape group reporting improvement compared with 49% (14/29) of the control tape group and 10% (3/29) of the no tape group. Significantly greater improvement in pain and disability was observed on most secondary outcomes in the therapeutic tape group compared with the no tape group. Benefits of therapeutic tape were maintained three weeks after stopping treatment. <b>Conclusions</b> Therapeutic knee taping is an efficacious treatment for the management of pain and disability in patients with knee osteoarthritis.
A REPORT OF SIX CASES OF ARSENICAL POISONING CAUSED BY FUMES FROM A COKE STOVE
Authors: J. G. Taylor, K. V. Trubshaw
Journal: BMJ (1911)

ARSENICAL POISONING BY FU3mES FROM COKE STOVE r(,.r59T4. Water fromil the salme source allowe-d to stand for a few days or w-eeks in clean stoppered bottles constantly produced higlh fever after boiling.The amount of fever was always nearly proportionate to the volume injected.Several hundred observations were m-cade.The total residue from 225 c.em. of water tllat lhad stood for miiany weeks was 2.2 mg.Two different samples were platedl out.(a) The water that had stood for two months gave 40 organisms per ce.n.(b) The water that stood for ten days gave 73,000 organisms per c.cm.The counts in all cases were made from agar plates grown for forty-eiglht lhours at 370 C. CoLnts made from agar plates at 22' C. wvere taken on two occasions and gave very silmlilar restl'us.The water that eontained 40 organisms per cern.gave a greater fever tlhan that wlhiel gave 73,000 organisms-.Botlh tllese waters were centrifugalized for tllirty minutes in Dr. Martin's turbine centrifuae.Smuall quantities. of the upper layers immediately below the surface invariably gave rise to higlh fever.The invisible deposit wrhen in- jected in 0.50 c.cm. of water gave rise to no disturbance of temperature.5. Distilled water that had been allowed to stand gave rise to fever after filtration either through a Doulton filter or through cotton-wool.Two filters wcre used.O1e was new, the otlher hacl been used several timiies.In botlh cases after filtration the water showed on analysis considerable quiantities of calciuLm.Before filtration the ainmoniium oxalate test gave no reaction.The same results were obtained w%vith a Berlkefeld filter.
Metabolism of γ-hydroxybutyrate to d-2-hydroxyglutarate in mammals: further evidence for d-2-hydroxyglutarate transhydrogenase
Authors: Eduard A. Struys, Nanda M. Verhoeven, Erwin E.W. Jansen, Herman J. ten Brink, Maneesh Gupta, Terry G. Burlingame, Lawrence S. Quang, Timothy Maher, Piero Rinaldo, O. Carter Snead, Amy K. Goodwin, Elise M. Weerts, P. Rand Brown, Tonya C. Murphy, Mathew J. Picklo, Cornelius Jakobs, K. Michael Gibson
Journal: Metabolism (2006)
Stafford breast surgeons reply to BMJ news article
Authors: R. Gendy, R. Vidya
Journal: BMJ (2012)

The title of Dyer’s news story “Breast surgeons are referred to GMC for refusing to take part in a review of their unit” is factually incorrect.1 We, the breast surgeons in Stafford, have never refused a review of our unit. On the contrary, we were the first to recommend and fully support a broadly based review.

The unsatisfactory Cancer Peer Review report was related to the repeated problems in appointing a lead clinician and the uploading of incorrect information by management. The breast unit had no lead clinician for several months. This was followed by the appointment …