tbuckley/cabot-search huggingface dataset:
Prevention of Recurrent Pulmonary Embolism
Authors: N. L. Browse, M. L. Thomas, M. J. Solan, A. E. Young
Journal: BMJ (1969)

Fifty patients have been studied by bilateral phlebography following their first, or sometimes recurrent, pulmonary embolus. Nineteen were found to have fresh loose peripheral thrombus, and in eight of them the thrombus looked big enough to cause a major pulmonary artery obstruction and death. These 19 patients were treated by vein ligation in addition to anticoagulants. The incidence of recurrent embolism in the trial group is significantly lower than that found in a retrospective study of 50 patients treated with anticoagulants only. It is suggested that anticoagulants will not prevent all recurrent pulmonary emboli, and that phlebography, and if necessary surgery, should be part of the routine investigation and treatment of all patients after their first pulmonary embolus.
Alarm call over reality gameshow
Authors: J. Lyall
Journal: BMJ (2004)

Doctors fear programme might have belittled dangers of sleep deprivation

A reality television gameshow that deprived contestants of sleep for a week and subjected them to tests including electric shocks has been criticised for exploitation.

Shattered —made by Endemol UK, which also produced Big Brother , and shown on Channel 4 last week (4 to 10 January inclusive)—featured 10 contestants, aged 19 to 33, living together in a purpose built studio in London's Docklands, where they underwent exercises designed to test memory, perception, reaction times, and mental agility. There was a “live elimination show” each evening to determine which contestant had lost the most function, and should therefore leave. The final remaining contestant would win the prize of a possible £100 000.

Contestants were allowed to sleep for up to two hours at a time, on the recommendation of the programme's medical advisers, but every “illegal sleep,” when a participant shut their eyes for …
High dose steroid treatment in cerebral infarction.
Authors: J W Norris, V C Hachinski
Journal: BMJ (1986)

Steroid treatment is widely used in acute cerebral infarction yet its value is controversial. High dose dexamethasone (480 mg over 12 days) was given in a double blind, randomised controlled trial to 113 consecutive eligible patients with acute cerebral infarction admitted to an acute stroke unit. Those with stroke for more than 48 hours, known embolic sources, diabetes, and infection were excluded. Death and quality of survival were recorded over 21 days. The active drug group (54 patients) matched the placebo group (59 patients) for age, initial stroke score, delay in beginning treatment, and other relevant variables. The two groups did not differ significantly in death rate or quality of survivorship. The small difference in mortality between the two groups may have represented a marginal therapeutic effect, which might reach significance in a larger sample. The widespread use of steroids in response to such a marginal therapeutic gain would expose large numbers of patients with stroke to more serious hazards of steroid treatment and convert patients who would otherwise have died into neurovegetative survivors. High dose steroid treatment was ineffective in ischaemic stroke, and the data suggest that further evaluation by a larger multicentre trial is not justified.
Problem based, small group learning
Authors: J. Bligh
Journal: BMJ (1995)

lung be punctured during the procedure this is most unlikely to lead to complications.'3Interventional radiologists also have the skills to carry out direct percutaneous puncture of the hepatic veins or inferior vena cava in patients in whom the jugular and subclavian veins cannot be used; they are, therefore, capable of offering a complete venous access service.
Dyskeratosis Congenita and Familial Pancytopenia
Authors: Henry G. Bryan
Journal: JAMA (1965)

Four or possibly five males in a kinship group had features of dyskeratosis congenita, a syndrome comprising poikiloderma atrophicans vasculare, dystrophia unguium, and leukoplakia oris. In addition, three members of the kinship demonstrated hematologic changes compatible with the hypoplastic anemia described by Fanconi. Based on the hemopoietic disturbance found in these three cases and that observed in seven similar cases from the literature, it is believed that the abnormalities associated with dyskeratosis congenita should be considered a further variant of the diverse congenital defects encompassed by the syndrome of Fanconi's familial pancytopenia.
ABC of diabetes: Retinopathy
Authors: P. J Watkins
Journal: BMJ (2003)

Blindness is one of the most feared complications of diabetes but also one of the most preventable. Diabetes is the commonest cause of blindness in people aged 30 to 69 years. Twenty years after the onset of diabetes, almost all patients with type 1 diabetes and over 60% of patients with type 2 diabetes will have some degree of retinopathy. Even at the time of diagnosis of type 2 diabetes, about a quarter of patients have established background retinopathy. Treatment can now prevent blindness in the majority of cases, so it is essential to identify patients with retinopathy before their vision is affected.
The hepcidin circuits act: Balancing iron and inflammation
Authors: Bryan D. Maliken, James E. Nelson, Kris V. Kowdley
Journal: Hepatology (2011)

Abstract Hepcidin is a peptide hormone that regulates iron homeostasis and acts as an antimicrobial peptide. It is expressed and secreted by a variety of cell types in response to iron loading and inflammation. Hepcidin mediates iron homeostasis by binding to the iron exporter ferroportin, inducing its internalization and degradation via activation of the protein kinase Jak2 and the subsequent phosphorylation of ferroportin. Here we have shown that hepcidin-activated Jak2 also phosphorylates the transcription factor Stat3, resulting in a transcriptional response. Hepcidin treatment of ferroportin-expressing mouse macrophages showed changes in mRNA expression levels of a wide variety of genes. The changes in transcript levels for half of these genes were a direct effect of hepcidin, as shown by cycloheximide insensitivity, and dependent on the presence of Stat3. Hepcidin-mediated transcriptional changes modulated LPS-induced transcription in both cultured macrophages and in vivo mouse models, as demonstrated by suppression of IL-6 and TNF-α transcript and secreted protein. Hepcidin-mediated transcription in mice also suppressed toxicity and morbidity due to single doses of LPS, poly(I:C), and turpentine, which is used to model chronic inflammatory disease. Most notably, we demonstrated that hepcidin pretreatment protected mice from a lethal dose of LPS and that hepcidin-knockout mice could be rescued from LPS toxicity by injection of hepcidin. The results of our study suggest a new function for hepcidin in modulating acute inflammatory responses. (HEPATOLOGY 2011 )
Ready or Not — Preparedness for Bioterrorism
Authors: Ali S. Khan, David A. Ashford
Journal: New England Journal of Medicine (2001)

Glanders is a zoonotic disease of horses and related equids that was eliminated from the United States in 1934. The etiologic agent, Burkholderia mallei, has occasionally caused severe infection in humans after the transmission of small aerosolized particles from infected animals, and B. mallei was used for biologic warfare, directed against the horses of the Allied armed forces, during World War I. Before the case reported by Srinivasan et al. in this issue of the Journal, 1 the last infections in humans in the United States occurred in 1945 among laboratory personnel working on a biologic-weapons program at Camp Detrick, Maryland. . . .
Transient Global Amnesia.
Authors: Harold Stevens
Journal: Annals of Internal Medicine (1973)

Meeting Abstracts1 May 1973Transient Global Amnesia.Harold Stevens, M.D., F.A.C.P.Harold Stevens, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-5-830_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEleven cases of transient global amnesia were studied with follow-up periods varying from 2 months to 18 years. In addition to neurological examination, EEG's were done on all; three patients showed abnormal results. The semeiology was found to be stereotyped, diagnosis easy. Although considered rare, many instances are probably mislabeled hysterical fugue states.Transient global amnesia is a readily recognizable entity, characterized by sudden spontaneous onset of amnesia, with preservation of consciousness and self-identity. The patient is keenly aware of his defect, struggles to regain his memory and reconstruct the mnemic points of reference. Remote memory is preserved, neurological examination... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Washington, D.C. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1973Volume 78, Issue 5Page: 830-830KeywordsAmnesiaConsciousnessElectroencephalographyMemory Issue Published: 1 May 1973 PDF DownloadLoading ...
Computer-Based Medical Translator System Helps Bridge Language Gap Between Physician, Patient
Authors: Phil Gunby
Journal: JAMA (1995)

THE PATIENT does not speak English. In fact, the physician is uncertain what language the patient does speak. Enter, the Multimedia Medical Language Translator. Because it is involved in medicine— and additionally because it was "born" and now is serving in the US military— this translation device naturally is known by its initials. In this case, they are MLT (for Medical Language Translator). <h3>Computer-Based System</h3> And what exactly is the MLT? Distributed as a CD-ROM disc (compact disc read-only memory), MLT is a computer-based system that is run on a laptop-size personal computer. In medical use, it allows the physician to determine which language the patient is familiar with, to ask questions and give directions or explanations in that language (via the recorded voice of a native speaker), and to have the patient's responses translated to English. The phrases available to the physician are designed to elicit brief responses (yes
Treatment of amiodarone induced thyrotoxicosis with carbimazole alone and continuation of amiodarone.
Authors: P. H. Davies, J. A. Franklyn, M. C. Sheppard
Journal: BMJ (1992)

Prevalence of tobacco advertising on post offices in deprived and non-deprived wvards Post offices in Post offices in Iwith Yates's deprived wards othcr wards correction; (n= 16, n --70) df-1 p Value No( %) carrying adverts 11 (68 8) 29 (41 4) 2 9 0-089 No (%) with adverts on two ormore sites 5 (31-2) 15 (21-4) 0(3 0-61 No ('%,) with area of adverts 1 m2 8(50-0) 17(24-3) 3-0 0 08Seventy five post offices (87-2%) sold non-post items, and 51 (59 3%) sold cigarettes.Post offices selling cigarettes were significantly less likely than those not selling cigarettes to ban smoking on the premises ( 1/51 v 16/33 odds ratio 0 3, 95% confidence interval 0 1 to 0 8; x) test with Yates's correction = 5 5; p=O009).No details on smoking bans were obtained in two shops.Post offices in deprived areas were more likely to carry tobacco advertising and to have a larger area of tobacco advertisements, although these dif- ferences fell short of statistical significance (table).
Managing the challenge of chemically reactive metabolites in drug development
Authors: B. Kevin Park, Alan Boobis, Stephen Clarke, Chris E. P. Goldring, David Jones, J. Gerry Kenna, Craig Lambert, Hugh G. Laverty, Dean J. Naisbitt, Sidney Nelson, Deborah A. Nicoll-Griffith, R. Scott Obach, Philip Routledge, Dennis A. Smith, Donald J. Tweedie, Nico Vermeulen, Dominic P. Williams, Ian D. Wilson, Thomas A. Baillie
Journal: Nature Reviews Drug Discovery (2011)
East Kent trust is placed in special measures after being rated inadequate
Authors: N. Hawkes
Journal: BMJ (2014)

The hospital trust that provides services to more than 750 000 people across east Kent has been found to be inadequate—the worst possible rating—by the Care Quality Commission (CQC), which recommended that it be placed in special measures.1

East Kent Hospitals University NHS Foundation Trust runs three hospitals, at Ashford, Canterbury, and Margate, as well as two community hospitals—Buckland in Dover and the Royal Victoria in Folkestone. The CQC found that the trust was inadequate in safety and leadership and that it required improvement in effectiveness and responsiveness. Only in caring was the trust’s performance rated good.

The verdict was reached after two prearranged visits to the hospitals early in March by a team of 57 chaired by Diane Wake, chief executive of Barnsley Hospital, and a further inspection that took place without …
Cold Exposure-induced Rhabdomyolysis Demonstrated by Bone Scintigraphy
Authors: Seok Tae Lim, Myung-Hee Sohn, Hwan-Jeong Jeong
Journal: Clinical Nuclear Medicine (2008)

This report describes a case of acute renal failure due to rhabdomyolysis that developed after prolonged exposure to cold. A 47-year-old man visited a mountain during winter wearing only casual clothes and became lost at temperatures below freezing for 8 hours. Upon admission, the patient complained of a tingling sensation and numbness in the both upper and lower extremities with anuria. The serum blood urea nitrogen, creatinine, creatinine kinase, and myoglobin levels were elevated. Bone scintigraphy on the second day revealed increased activity in the superficial muscle groups in the abdomen, back, buttock, thighs, legs, and arms, which was compatible with rhabdomyolysis.
CORTICOSTEROID RELEASE AND SYNTHESIS IN VITRO BY ADRENAL SLICES FROM PATIENTS WITH CUSHING'S SYNDROME*
Authors: Patrick J. Mulrow, George L. Cohn
Journal: Journal of Clinical Investigation (1961)

Histological methods cannot accurately assess the functional capacity of the human adrenal cor- tex.About 36 per cent of patients with Cushing's syndrome are reported to have adrenal glands nor- mal in weight and histological appearance (1, 2).Adrenal adenomas are considered functional only if they are associated with atrophy of non- adenomatous adrenal tissue.Moreover, certain tumors of the adrenal medulla and kidney cannot be distinguished from cortical neoplasms by his- tological techniques (3).Several recent reports have demonstrated that the human adrenal cortex retains much of its ac- tivity in vitro (X11).Adrenal homogenates or slices have been found to produce steroids, in- corporate precursors into more complex com- pounds, and respond to ACTH.1 Cooper and co-workers showed that adrenal slices produced the same corticosteroids in vitro that were found in adrenal vein blood (8).Bongiovanni (9) dem- onstrated that homogenates of adrenals from pa- tients with congenital adrenocortical hyperplasia were unable to hydroxylate the 21-carbon atom of steroid precursors, a defect present in vivo.Incubation experiments with rat, ox, and human adrenal slices indicate that the steroids are readily released into the incubation media (10-14) ; this technique therefore affords the opportunity to in- vestigate directly the function and biosynthesis of steroids by human adrenal tissue.
Crohn's Colitis Associated with Granulomatous Bone Disease
Authors: F. Warren Nugent, David Glaser, Luis Fernandez-Herlihy
Journal: New England Journal of Medicine (1976)

A Variety of bone and joint manifestations of Crohn's disease have been reported,1 2 3 including ankylosing spondylitis,1 nonspecific synovitis,4 periosteal new-bone formation,5 6 7 and aseptic necrosis.5 One case of granulomatous synovitis has been reported.8 The unusual case of Crohn's disease of the colon reported below was complicated by granulomatous disease of bone.Case ReportA 44-year-old man complained of severe bilateral leg pain progressing, in one month, to the point that he was having difficulty walking. He also complained of mild abdominal distention.Physical examination gave normal results. Urinalysis, complete blood count, glucose, urea nitrogen, cholesterol, uric acid, total protein with albumin-globulin . . .
Phrenic Nerve Stimulation as a Complication of the Implantable Cardiac Pacemaker
Authors: JAMES D. SPRINKLE, TIMOTHY TAKARO, STEWART M. SCOTT
Journal: Circulation (1963)

T HE implantable cardiac pacemaker has rapidly become an essential modality in the clinical management of medically refrac- tory Stokes-Adams disease.In spite of in- creasing refinement in both the myocardial electrodes and the pacemaker, significant com- plications still occur and are discussed in representative papers by Chardack1 and Zoll.2The unusual complication of phrenic nerve stimulation was recently encountered after insertion of a Chardack pacemaker.Since this proved to be troublesome and has not been previously reported, it seemed to be worth recording.Case Summary J.C.S., a 36-year-old white man, was admitted to the Veterans Administration Hospital, Oteen, North Carolina, June 1959, with symptoms of in- creasing exertional dyspnea, precordial pain, and fullness in the head dating back to January 1959.He was found to have idiopathic atrioventricular block varying from second degree to complete dissociation.unresponsive to medical treatment.In Februaiy 1960, while driving a truck, he suffered his first Stokes-Adams attack.A compression fracture of the sixth dorsal vertebra and disloca- tion of the left acromioclavicular joint were sus- tained.Syncopal episodes recurred February, April, and Julv 1961.On the day of admission, September 25, 1961, three Stokes-Adams attacks occurred.Physical findings included pulse rate of 48 per minute and blood pressure in the anr of 130/70.The cardiac size was normal to per- cussion.There was a grade-Il apical systolic mur- mur and no evidence of congestive heart failure.Adm-iission electrocardiogrami showed atrioventric- ular block varying between 2 to 1 and 3 to 1.The atrial rate was 96 per mninute and ventricular rates were 32 to 48 per minute.On September 28, 1961, a Chardack internal pacemaker and electrodes were implanted.The pericardium was opened anterior to the phrenic nerve and the electrodes were inserted into the
Blood pressure and mortality in elderly people aged 85 and older: community based study
Authors: H. C Boshuizen, G. J Izaks, S. van Buuren, G. J Ligthart
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective:</b> To determine whether the inverse relation between blood pressure and all cause mortality in elderly people over 85 years of age can be explained by adjusting for health status, and to determine whether high blood pressure is a risk factor for mortality when the effects of poor health are accounted for. <b>Design:</b> 5 to 7 year follow up of community residents aged 85 years and older. <b>Setting:</b> Leiden, the Netherlands. <b>Subjects:</b> 835 subjects whose blood pressure was recorded between 1987 and 1989. <b>Main outcome measure:</b> All cause mortality. <b>Results:</b> An inverse relation between blood pressure and all cause mortality was observed. For diastolic blood pressure crude 5 year all cause mortality decreased from 88% (52/59) (95% confidence interval 79% to 95%) in those with diastolic blood pressures &lt;65 mm Hg to 59% (27/46) (44% to 72%) in those with diastolic pressures &gt;100 mm Hg. For systolic blood pressure crude 5 year all cause mortality decreased from 85% (95/112) (78% to 91%) in those with systolic pressures &lt;125 mm Hg to 59% (13/22) (38% to 78%) in those with systolic pressures &gt;200 mm Hg. This decrease was no longer significant after adjustment for indicators of poor health. No relation existed between blood pressure and mortality from cardiovascular causes or stroke after adjustment for age and sex, but after adjustment for age, sex, and indicators of poor health there was a positive relation between diastolic blood pressure and mortality from both cardiovascular causes and stroke. <b>Conclusion:</b> The inverse relation between blood pressure and all cause mortality in elderly people over 85 is associated with health status. <h3>Key messages</h3> Among community residents aged 85 and older there was a paradoxical inverse relation between blood pressure and all cause mortality: higher blood pressure was associated with lower mortality This inverse relation seems mainly to be due to higher mortality in those with low blood pressure; low blood pressure seems to be caused by poor health There was no longer a significant relation between blood pressure and all cause mortality after adjusting for health status. However, there was a positive relation between diastolic blood pressure and mortality from both cardiovascular causes and stroke Treating hypertension does not shorten life expectancy among elderly people aged 85 and older, and it might prevent disability from stroke
Uveal Involvement in Systemic Angiotropic Large Cell Lymphoma
Authors: Selwa A.F. Al-Hazzaa, W. Richard Green, Risa B. Mann
Journal: Ophthalmology (1993)

Background: Angiotropic large cell lymphoma is a rare, generally fatal disease characterized by multifocal proliferation of neoplastic mononuclear cells within the lumens of blood vessels. Methods: The authors report the clinical and immunohistochemical features of four patients with angiotropic large cell lymphoma. Results: All patients presented with central nervous system symptoms, and three of the four had fever of unknown origin and anemia. The diagnosis was established by postmortem examination of the eyes in four patients and additionally by autopsy in three of the four patients. Two of the three autopsied patients had rare foci of extravascular involvement. One patient had erythrophagocytosis. Immunohistochemical stains on paraffin-embedded sections confirmed the diagnosis of lymphoma in all four patients. Conclusion: The results of this study support the B-cell lymphocyte origin of angiotropic large cell lymphoma. Background: Angiotropic large cell lymphoma is a rare, generally fatal disease characterized by multifocal proliferation of neoplastic mononuclear cells within the lumens of blood vessels. Methods: The authors report the clinical and immunohistochemical features of four patients with angiotropic large cell lymphoma. Results: All patients presented with central nervous system symptoms, and three of the four had fever of unknown origin and anemia. The diagnosis was established by postmortem examination of the eyes in four patients and additionally by autopsy in three of the four patients. Two of the three autopsied patients had rare foci of extravascular involvement. One patient had erythrophagocytosis. Immunohistochemical stains on paraffin-embedded sections confirmed the diagnosis of lymphoma in all four patients. Conclusion: The results of this study support the B-cell lymphocyte origin of angiotropic large cell lymphoma.
On the Management of Fibromyomata Complicating Pregnancy and Labour
Authors: J. Phillips
Journal: BMJ (1888)

plainig its mode of action, we could not in future ignore the nuestions: What changes does it call forth in the texture of the sbin?IIow does it modify the great thermolytic function of radiation ?Another subject connected with thermolysis deserved some mention, namely the connection of peripheral temnperatures with central.The lecturer, in common with many others, had been
Influence of patients' expectations on disease
Authors: S Ife
Journal: BMJ (1994)

EDITOR, - Michael Loudon continues the debate about the contribution of psychological factors to the development of the chronic fatigue syndrome and the influence of patients' expectations on the prognosis.1

I developed glandular fever over a year ago. For three months earlier this year I had considerable but variable difficulty in getting out of bed in the morning, muscle “woodenness” all over, and wobbly legs in association with …