tbuckley/cabot-search huggingface dataset:
Not All Drug Firms Subject to Gifts Guidelines, But, for Physicians, Their Gifts Are Still Tabooj
Authors: Teri Randall
Journal: JAMA (1991)

WHILE the Pharmaceutical Manufacturers Association (PMA) has agreed to enforce among its members the American Medical Association's (AMA's) guidelines concerning gifts from industry, non-PMA members fall outside the association's authority. The situation has created an open loop in which it is not technically unethical for nonmember companies to offer extravagant gifts, yet it is unethical for physicians to accept them. <h3>Firm Offers 'Educational Cruise'</h3> Ethics codes are not the law, however, and a recent promotion by a biomedical company indicates that many physicians still are more than willing to accept these gifts. Collagen Corp, Palo Alto, Calif, is sending the 55 dermatologists who purchased the largest volume of injectable collagen between July 1990 and March 1991 on an 8-day "educational cruise" in the South Pacific, all expenses paid. Winners of the trip were notified last month and the cruise is scheduled for late June. Howard D. Palefsky, chief executive officer
Pregnancy, hair loss, and the pill.
Authors: R P Dawber, B L Connor
Journal: BMJ (1971)

A patient developed diffuse hair loss 2 months after cessation of oral contraceptive therapy.  9 months later she became pregnant and 2 months after delivery severe hair loss recommenced.  No clinical abnormalities were detected.  The similarity in type and timing of excessive hair loss both after stopping ovulen therapy and after pregnancy supports the theory that pathogenesis is the same in both situations.
Double‐blind, randomized, placebo‐controlled trial of effect of nedocromil sodium on clinical and inflammatory parameters of asthma in children allergic to dust mite
Authors: I. Stelmach, J. Jerzynska, A. Brzozowska, P. Kuna
Journal: Allergy (2001)

Background: The purpose of this study was to determine the clinical effect of nedocromil sodium and its relationship with serum levels of inflammatory mediators by monitoring lung function and noninvasive markers of airway inflammation, such as eosinophil blood counts; serum ECP, sIL‐2R, IL‐4 and sICAM; and total IgE. Anti‐inflammatory medications cause a reduction in the markers of airway inflammation, decrease the intensity of airway hyperresponsiveness, and improve clinical symptoms of asthma. Among the available choices is nedocromil sodium, which is favored in the treatment of asthmatic children due to its very mild side‐effects. It has been previously shown to improve the clinical parameters of asthma, but there are limited data on its effect on inflammatory mediators in the serum of asthmatic children. Methods: In this double‐blind, randomized, placebo‐controlled 8‐week trial, 39 children, aged 9–16 years, with moderate atopic asthma were randomly allocated to receive either nedocromil sodium, two puffs twice daily, 0.002 g/puff, or placebo, two puffs twice daily. The primary end points were the clinical parameters of asthma measured by asthma symptom score, FEV 1 , and PC 20H . Other end points included the serum levels of various inflammatory markers – ECP, sIL‐2R, IL‐4, sICAM, and IgE. Results: Clinical and inflammatory parameters improved with the use of nedocromil sodium, compared with placebo. Nedocromil significantly decreased serum levels of inflammatory markers, as shown in the following table. No correlation was found between any of the measured parameters. Conclusions: Nedocromil sodium provided effective anti‐inflammatory treatment for children with moderate atopic asthma.
Postjunctional electrical mechanisms of enteric neurotransmission
Authors: K M Sanders
Journal: Gut (2000)

The contractile behaviour of gastrointestinal smooth muscles is dependent on the intrinsic electrical activities of the muscles.1 Depolarisation activates L-type Ca2+channels that provide the main pathway for Ca2+ to enter gastrointestinal smooth muscle cells. This is particularly true for the phasic portions of the gastrointestinal tract where cyclic depolarisations and repolarisations, referred to as slow waves, set the contractile frequency and maintain the phasic nature of contractions (fig 1). The slow wave cycle ensures a period of relaxation between contractions, allowing mixing and movement of luminal contents. Tonic regions of the gastrointestinal tract, such as the sphincters, are also regulated by electrical events but primarily by more persistent changes in resting membrane potential.



Figure 1 
Organisation of electrical activity in phasic gastrointestinal muscles. ICC, interstitial cells of Cajal.



In addition to the ionic conductances that contribute to resting membrane potential and electrical rhythmicity, there are several ionic conductances that are modulated by neural and hormonal inputs. Regulatory inputs from nerves, hormones, and paracrine substances are superimposed on the spontaneous electrical activity of gastrointestinal muscles. Electrical responses to biologically active substances result from: (i) modulation of ionic conductances that are already active and going through dynamic changes in open probability during the slow wave cycle; and (ii) activation of agonist dependent conductances that do not participate in basal electrical activity. Ca2+ entry into smooth muscles is mainly controlled by rather subtle changes in the open probability of L-type Ca2+channels.2 3 The more frequently these channels open and the longer they stay open, …
Doctors threaten to withdraw subscriptions to GMC if they are not allowed to regulate themselves
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

Doctors have voted to withhold their subscriptions from their regulatory body, the General Medical Council, if proposals to end self regulation are implemented.

They have promised a sustained attack on the government's plans in the white paper Trust, Safety and Assurance—The Regulation of Health Professionals in the 21st Century , published in February, and a direct campaign to protect the facility to regulate themselves.

Doctors at the annual representative meeting in Torquay ran out of adjectives to describe their feelings about the government's plan to run the GMC with a lay majority of government appointees, claiming themselves “horror-struck,” “aghast,” “shocked,” “dismayed,” “revolted,” and “appalled.” 

Derek Machin, member of council and the consultants' committee, who proposed the motion said: “We want to be nominated by grassroots doctors and be accountable to the profession.” 

He accused Dame Janet Smith, who conducted an inquiry on the serial murderer Harold Shipman which led to the proposed changes for doctors' regulation, as taking “a murderer and [using] him as an example of how to regulate us.”

“The GMC has …
Remediable Arterial Disease
Authors: Alan T. Marty
Journal: JAMA (1972)

Attention to fine details of vascular reconstructive technique and espousal of good surgical judgment characterize this short monograph. The strength and usefulness of this book lie in its chapters on the methods of evaluation and restoration of arterial circulation. Clear, pertinent discussions of the history and physical examination, and the sections on the indications for and interpretation of angiograms especially stand out. All surgeons doing vascular surgery will benefit from the 94 pages devoted to "procedures in atherosclerosis." This central core sparkles with practical information on thromboendarterectomy, bypass grafts, procedures for acute ischemia, and the surgical management of disease in every peripheral artery. "A principal thesis of this book is that<i>each</i>detail is<i>the</i>most important one." While little is said about complications, the authors can only blame the surgeon "when intrinsic circumstances favored restoration, but information that might have been helpful was not used (eg, angiography) or oversight
Hear the Silence
Authors: M. Fitzpatrick
Journal: BMJ (2003)

A forthcoming drama about the MMR controversy has angered many doctors. A general practitioner and two child health experts, who have all seen a preview, explain why

Channel 5, 15 December at 9 pm

H ear the Silence is Channel 5's dramatisation of the case that the measles, mumps, and rubella (MMR) vaccine causes autism. Gastroenterologist Andrew Wakefield, whose 1998 paper ( Lancet 1998;351: 637) first led to claims of a link between MMR and autism, is played by actor Hugh Bonneville. We see him introduce himself as the caring, listening doctor to Nicky (Jamie Martin), a little boy with autism, and his mother, Christine (Juliet Stevenson). “Hello, I'm Andy,” he says. At his positive response to Christine's conviction that MMR caused her son's bowel problems and his autism, she bursts …
Enhanced suppression of inflammation after coronary stenting (ESIS): A randomized clinical trial comparing Abciximab and eptifibatide
Authors: Atul Aggarwal, David J. Schneider, Edward F. Terrien, Christopher M. Terrien, Matthew W. Watkins, Samer S. Kabbani, Harold L. Dauerman
Journal: Journal of the American College of Cardiology (2003)
Comparison of Surgical Septal Myectomy and Alcohol Septal Ablation With Cardiac Magnetic Resonance Imaging in Patients With Hypertrophic Obstructive Cardiomyopathy
Authors: Uma S. Valeti, Rick A. Nishimura, David R. Holmes, Philip A. Araoz, James F. Glockner, Jerome F. Breen, Steve R. Ommen, Bernard J. Gersh, A. Jamil Tajik, Charanjit S. Rihal, Hartzell V. Schaff, Barry J. Maron
Journal: Journal of the American College of Cardiology (2007)
Low Adiponectin Levels and Increased Risk of Type 2 Diabetes in Patients With Myocardial Infarction
Authors: Søren Lindberg, Jan S. Jensen, Sune H. Pedersen, Søren Galatius, Jan Frystyk, Allan Flyvbjerg, Mette Bjerre, Rasmus Mogelvang
Journal: Diabetes Care (2014)

OBJECTIVE Patients with acute myocardial infarction (MI) have increased risk of developing type 2 diabetes mellitus (T2DM). Adiponectin is an insulin-sensitizing hormone produced in adipose tissue, directly suppressing hepatic gluconeogenesis, stimulating fatty acid oxidation and glucose uptake in skeletal muscle and insulin secretion. In healthy humans, low plasma adiponectin levels associate with increased risk of T2DM; however, the relationship between adiponectin and T2DM in patients with MI has never been investigated. RESEARCH DESIGN AND METHODS We prospectively included 666 patients with ST-segment elevation MI, without diabetes, treated with percutaneous coronary intervention, from September 2006 to December 2008 at a tertiary cardiac center. Blood samples were drawn before intervention, and total plasma adiponectin was measured in all samples. During follow-up (median 5.7 years [interquartile range 5.3–6.1]) 6% (n = 38) developed T2DM. Risk of T2DM was analyzed using a competing risk analysis. RESULTS Low adiponectin levels were associated with increased risk of T2DM (P &amp;lt; 0.001). Even after adjustment for confounding risk factors (age, sex, hypertension, hypercholesterolemia, current smoking, previous MI, BMI, blood glucose, total cholesterol, HDL, LDL, triglyceride, estimated glomerular filtration rate, C-reactive protein, peak troponin I, and proatrial natriuretic peptide), low adiponectin levels remained an independent predictor of T2DM (hazard ratio [HR] 5.8 [2.3–15.0]; P &amp;lt; 0.001). Importantly, plasma adiponectin added to the predictive value of blood glucose, with the combination of high blood glucose and low plasma adiponectin, vastly increasing the risk of developing T2DM (HR 9.6 [3.7–25.3]; P &amp;lt; 0.001). CONCLUSIONS Low plasma adiponectin levels are independently associated with increased risk of T2DM in patients with MI and added significantly to the predictive value of blood glucose.
Long-term chemical carcinogenesis experiments for identifying potential human cancer hazards: collective database of the National Cancer Institute and National Toxicology Program (1976-1991).
Authors: J Huff, J Haseman
Journal: Environmental Health Perspectives (1991)

The carcinogenicity database used for this paper originated in the late 1960s by the National Cancer Institute (NCI) and since 1978 has been continued and made more comprehensive by the National Toxicology Program (NTP). The extensive files contain, among other sets of information, detailed pathology data on more than 400 long-term (most often 24-month) chemical carcinogenesis studies, comprising nearly 1600 individual experiments having at least 10 million tissue sections that have been evaluated for toxicity and carcinogenicity.(ABSTRACT TRUNCATED AT 250 WORDS)
Cognitive therapy for depression.
Authors: D Goldberg
Journal: BMJ (1982)

different regions of Britain to compare mortality rates for breast cancer among screened populations, populations intensively instructed in breast self-examination, and control areas left without the putative benefit of either strategy.It will be many years before any definitive data are available.Meanwhile, a recent report in Cancer4 is encouraging.In this retrospective study of over 2000 women with breast cancer from the Georgia Cancer Management Network the practice of breast self-examination was compared with the stage of presentation at diagnosis.Sixty-seven per cent of the women reported that they practised breast self-examination, rising to 760, among those under 50.There were also the differences between social and educational subgroups.The anticipated proportion of cancers at a favourable stage was significantly higher for breast self-examination (84"'/) than for "self- accidental" discovery (74",).Furthermore, among the 1264 women practising breast self-examination whose axillary nodes were examined 57"),, did not contain tumour compared with 50",, of nodes from 560 women who did not practise breast self-examination.These pathological differences might eventually be expected to result in different death rates.The authors sensibly conclude that the early discovery of lumps in the breast and breast self-examination may not be causally related: both variables could reflect the health consciousness of the patient.They also go on to say that it is logistically and financially impossible to perform a prospective randomised trial to test this hypothesis-plainly, they had not heard of the current DHSS study.While accepting the enormous differences in cultural attitudes and health awareness between women in the United States and Britain I will use the Georgia experience to justify the practice of instructing women who attend my clinics in breast self-examination while awaiting the results of the DHSS study.I remain secure in my conviction that, apart from inducing occasional obsessional neurosis, breast self- examination is unlikely to do any harm.For other clinicians who agree I would recommend the leaflet produced by the Women's National Cancer Control Campaign, which provides good illustrations and clear instructions.5
On the Excretion of Urea.
Authors: Charles Stover
Journal: JAMA (1897)

minutes we prepared him hastily and opened the median basilic vein at the elbow flexure.Between two and three pints of very dark blood, which coagulated almost immedi¬ ately, was taken.Before the blood ceased flowing the cyanosis had given place to a bright red color, the pulse was improved and respiration much easier.Digitalis and atropin were given hypodermically.He continued to improve for forty five min¬ utes, then again failed rapidly.Respiration 60, pulse 160 to 175 per minute-at times uncountable.We gave up then, but I remained to see the end.At 8 :30 a. m. he seemed about to take his last breath, but rallied slightly and at 9 o'clock I decided to renew the fight.I sent for oxygen gas and at 10 a. m. gave the first inhalation, hav¬ ing meanwhile continued stimulation and administered a nutri¬ ent enema.At first the oxygen was given every ten minutes.At 11 a. m.I left him, still unconscious, but much improved.At 1 p. m.I returned and he greeted me with "Hello, Doctor !" Respiration at this time 60, but not labored ; pulse 160 ; axil¬ lary temperature at 3 :30 p. m., 105.June 12-Temperature 101.5 to 103 ; pulse 132 to 150; res¬ piration 38 to 50.Recovery was slow but complete.I have not the least doubt that the blood-letting was the primary means of saving this patient's life, though without the oxygen he would probably have died in spite of the bleeding.
The individual survival benefits of tumor necrosis factor soluble receptor and fluid administration are not additive in a rat sepsis model
Authors: Ping Qiu, Yan Li, Yi Ding, Jia Weng, Steven M. Banks, Steven Kern, Yvonne Fitz, Anthony F. Suffredini, Peter Q. Eichacker, Xizhong Cui
Journal: Intensive Care Medicine (2011)
The Dysuria-Pyuria Syndrome
Authors: Anthony L. Komaroff, Gerald Friedland
Journal: New England Journal of Medicine (1980)

Most clinicians immediately suspect a diagnosis of bacterial cystitis in a woman who has dysuria and frequent urination but no clinical evidence of upper-urinary-tract infection. Yet studies from the United Kingdom1 2 3 and the United States4 show that 30 to 50 per cent of women seeking primary care for these symptoms do not have a positive urine culture according to the traditional criterion: isolation of a presumed pathogen, in pure culture, in concentrations of > 105 bacteria per milliliter of urine in a cleanvoided specimen. We have reported one reason for this phenomenon4: dysuria may often represent a vaginal, not . . .
The dietary advice on added sugar needs emergency surgery
Authors: A. Malhotra
Journal: BMJ (2013)

Foods that we think of as junk are only half the problem

Are current guideline daily amounts (GDAs) fit for purpose? With a worsening obesity crisis and increasing prevalence of type 2 diabetes, this is a pertinent question. According to Professor Tom Sanders, head of nutritional sciences at King’s College London, “guideline daily amounts enable consumers to make informed choices on balancing their diet by identifying guideline levels for key nutrients and calories consumed each day and how much a portion of a particular food contributes to that allowance.” But do they? Before answering this we need to understand the history of our dietary advice.

In 2003, the World Health Organization, responding to increasing concerns over the rising tide of obesity, stated that “added sugars”—specifically non-milk extrinsic sugar—should contribute no more than 10% of total energy intake.1 This was in line with the UK government’s Committee on Medical Aspects of Food and Nutrition Policy (COMA) recommendations in 1991.2 COMA also recommended that consumption of fruit, vegetables, potatoes, and bread (containing intrinsic sugars) should increase by 50%. Consequently, Rayner et al, although maintaining that “added sugars” contribute no more than 10% of total energy, suggested that total sugars should contribute to 20% of guideline daily amounts.3

This nutritional advice has formed the basis of UK food labelling since 2003 and subsequently influenced European legislation. I believe that not only has this advice been manipulated by the food industry for profit but that added sugar is a risk factor for obesity and diet related disease.

In 2009, the American Heart Association published a scientific statement in Circulation entitled “Dietary sugar intake and cardiovascular health.” …
Increased Risk of Eczema Vaccinatum in Atopic Dermatitis Patients with a History of Herpetic Infections
Authors: M.D. Howell, L.J. Lesley, B.E. Kim, J.E. Streib, P. Taylor, D. Zaccaro, M. Boguniewicz, D.Y.M. Leung
Journal: Journal of Allergy and Clinical Immunology (2010)
Decline in Mortality with Varicella Vaccination
Authors: Raffaella Giacchino, Giuseppe Losurdo, Elio Castagnola
Journal: New England Journal of Medicine (2005)

To the Editor: Nguyen et al. (Feb. 3 issue)1 report on the effect of the U.S. varicella vaccination program on disease-related mortality. The effectiveness of such programs also includes reducing severe varicella-associated complications. In Italy, from 1995 to 2003, when no universal childhood varicella vaccination program was in effect, we documented 303 admissions (median age of patients, 4.2 years; range, 0 to 15) to a children's research hospital for varicella for a total of 2420 days of hospitalization. Thirty-nine patients (13 percent) had varicella-associated complications (1.2 percent of admissions for varicella), including 13 with central nervous system involvement and 7 . . .
Quitting smoking and gaining weight: the odd couple
Authors: E. Fernandez, S. Chapman
Journal: BMJ (2012)

We are grateful to Fernandez and Chapman for the interest in our work. We concur completely that the risk of weight gain should not deter people from quitting smoking. The reduction in risk from cessation far outweighs the risks from weight gain. However, we are concerned that the phrasing and some of the messages in the editorial may give the wrong impression. The authors suggest that the results may not apply to most smokers, seem to imply that the weight gain is temporary, and that the weight gain may not matter to health.
Decline in ischaemic heart disease in Iceland and change in risk factor levels.
Authors: N Sigfusson, H Sigvaldason, L Steingrimsdottir, I I Gudmundsdottir, I Stefansdottir, T Thorsteinsson, G Sigurdsson
Journal: BMJ (1991)

To monitor trends in mortality and morbidity due to ischaemic heart disease and compare these with observed levels of risk factors from population surveys.Analysis of trends in death rates from ischaemic heart disease in Iceland compared with expected rates computed from population surveys. Risk factor levels together with beta factors obtained from Cox's regression analysis were used to compute expected death rates. Trends in morbidity due to acute myocardial infarction were assessed and secular trends in dietary consumption compared with trends in cholesterol concentrations.Reykjavik, Iceland (total population 250,000; over half the population live in Reykjavik).12,814 randomly selected residents in the Reykjavik area aged 45-64 (6623 men, 6191 women; 72% and 80% of those invited).Age adjusted rates of myocardial infarction and deaths from ischaemic heart disease. Expected risk from risk factor levels (smoking, total serum cholesterol concentration, systolic blood pressure) at each unique survey visit.Mortality from ischaemic heart disease has decreased by 17-18% since 1970. During 1981-6 the myocardial infarction attack rate in men under 75 decreased by 23%. A decrease occurred in the level of all three major risk factors after 1968. The fall in the serum cholesterol concentration coincided with a reduction in consumption of dairy fat and margarine. The calculated reduction in risk for the age group 45-64 was about 35%, which was closely similar to the observed decrease in mortality due to ischaemic heart disease in that age group.The reduction in mortality from ischaemic heart disease was substantially due to a decreased incidence of myocardial infarction and could be attributed largely to the reduction in risk factors.
Prevention of Hypoglucosemia by Fructose in Infants of Diabetic Mothers
Authors: Michael L. McCann, Peter A. J. Adam, Beverly F. Likly, Robert Schwartz
Journal: New England Journal of Medicine (1966)

HYPOGLUCOSEMIA occurs consistently in infants of insulin-dependent diabetic mothers during the initial hours of life.1 2 3 4 Previous studies have not clearly related symptomatology to the level of blood glucose.5 6 7 Furthermore, the effect of hypoglucosemia on mortality, morbidity and ultimate mental development is not well defined.The following observations suggest that subtle as well as overt symptoms regularly occur in the initial hours of life in association with hypoglucosemia. Fructose administration was found to alleviate symptoms and to alter the course of blood glucose.MethodsIn addition to the methods and material previously described4 7 infants received fructose directly into the umbilical . . .