tbuckley/cabot-search huggingface dataset:
Distinction and merit awards: a 100m pound management tool?
Authors: J. Raftery
Journal: BMJ (1989)

working paper is whether the reward is for aggregated underspending by a family practitioner committee or whether all general practitioner practices should have an expenditure outturn within, say, 5% of budget.The sanction of last resort against those practices which overspend on their drug budget is to withhold doctors' remuneration.Such action is likely to create some interesting contractual problems because it is the individual doctor who is in contract with the family practitioner committee but the practice which will hold the indicative drug budget.In conclusion, little indication is given in the working paper as to how the success or failure of the proposals will be evaluated.If the test is to be one of improved cost effectiveness the monitoring of reduced drug expenditure alone is inadequate.Data are required on the quality of patient care and treatment outcomes to determine whether they can be main- tained, or even improved, at lower cost.The proposals are to be tried out in 1990-1; I hope that comparative trials will be designed to address questions of effective- ness as well as of cost.
Medical or surgical orchidectomy?
Authors: D J Chadwick, D A Gillatt, J C Gingell
Journal: BMJ (1991)

9% of the patients in their study receiving menopausal therapy?And how do oestrogens achieve their beneficial effects?Why when Mr Wilkes and Dr Meade report such enthusiasm for oestrogen replacement therapy among the general practitioners they surveyed were so few women receiving treatment?In our experience many general practitioners are less enthusiastic.We see many women who are given only a few months' or at most one year's treatment by their general practitioner.Shears reported that 82% ofgeneral practitioners in Brighton considered the optimum duration of oestrogen replacement therapy to be less than one year.6Epidemiological studies, however well designed, will not tell us how oestrogens prevent bone mineral loss or coronary thrombosis.No amount of epidemiology could show that oestrogen receptors are widely distributed on the heart and blood vessels of primates including humans7 or that oestrogens dilate peripheral blood vessels8 and increase cardiac output in animals9 and women' and prevent coronary artery thrombosis in monkeys fed an atherosclerotic diet.'0Nor is the "most controversial issue... the place of unopposed oestrogen in treating women who have not under- gone hysterectomy" as Mr Wilkes and Dr Meade suggest.5Oestrogen replacement therapy has been avail- able since the 1940s, and the first placebo controlled study of its beneficial effects was reported in 1950.1"So instead of advocating yet more trials of the effects of particular therapeutic regimens an epidemiological unit could well ask why, 40 years later, 91% of British women are missing out on treatment that reduces mortality and morbidity and improves their quality of life.
Chlamydia psittaci-negative ocular adnexal marginal zone B-cell lymphomas have biased VH4-34 immunoglobulin gene expression and proliferate in a distinct inflammatory environment
Authors: F van Maldegem, T A M Wormhoudt, M M S Mulder, M E C M Oud, E Schilder-Tol, A R Musler, J Aten, P Saeed, M J Kersten, S T Pals, C J M van Noesel, R J Bende
Journal: Leukemia (2012)
Authors, Ghosts, Damned Lies, and Statisticians
Authors: Elizabeth Wager
Journal: PLoS Medicine (2007)

Since the earliest peer-reviewed publications of the late 17th century, conventions about the authorship of scientific papers—which were generally anonymous and attributed to the sponsor (in those days, usually the church or the king)—have evolved considerably [1]. Readers now want to know not only who paid for the research but also who did the work. Transparency (i.e., full disclosure) is now considered a moral responsibility, and many medical journals have introduced mechanisms for increasing transparency [2]. The International Committee of Medical Journal Editors (ICMJE) has also issued guidance on who qualifies for authorship [3], and their criteria have been updated and augmented several times in response to several authorship scandals [4]. Yet problems with authorship persist.
THE CEREBRAL FORM OF PERNICIOUS MALARIA
Authors: J. F. PATTERSON
Journal: JAMA (1913)

nary way of regulating the dose after the lirst.in practice in any event, that is, when the vaccines are-standardized as to numbers.CASE 1.-The patient, a university graduate and a high- school teacher, aged 28, had hud "hay-fever" regularly the past five or six years.It began usually about the end of July, and lasted until two or three weeks alter a heavy frost.July 30, 1911, 1.0 c.c. of vaccine were injected.No local or consti- tutional effect from the injection was noted.August (i the initient reported that he had not sneezed since the vaccination, and nasal discharge had been practically absent; 1 c.e. of the original vaccine was injected as a second dose.During the following week the patient went on duty from 0 a. m. until 11 a. m. daily, as ticket-seller at the local driving park.The air in the ticket-booth was foul from its incidental use as a privy, and the food furnished was so poor that it could not be eaten, so that the patient said he "lived on watermelon and buttermilk."lie had attacks of sneezing each morning, though little during the day.August 14, only 0.2 c.c. of a new vac- cine was injected but with no noticeable effect.August IS, 0.0 c.c. of the same vaccine used which had a, slight effect.August, 22, I ce was injected by the patient's uncle, a physician, which gave relief for twenty-four hours only.August 28, 1 c.c. of a new vaccine was given and the patient removed to a city on Lake.Erie to begin high-school work.He was convinced that he bad been better than for any of the past five years.He reported in the fall of 11)12 that for the past Bummer (not under treatment) his attacks had been scarcely one third as bad as normal.Cash 2-The patient, a university professor, had typical "hay-fever" for the past five or six years.It began usually about the middle of August, though this year he had been sneezing since July 1.Aug. 10, 11)11, 1.3 c.c. of vaccine was
Teichoic Acid Antibodies in Chronic Staphylococcal Osteomyelitis
Authors: PHILIP A. MACKOWIAK
Journal: Annals of Internal Medicine (1978)

Gel-diffusion and the enzyme-linked immunosorbent assay (ELISA) were used to quantify and to identify the immunoglobulin class of teichoic acid antibodies in patients with chronic staphylococcal osteomyelitis and a wide variety of other infections. Teichoic acid antibodies were identified by gel-diffusion in 14 of 23 patients with staphylococcal endocarditis, six of 30 with staphylococcal bacteremia without endocarditis, four of 35 with staphylococcal skeletal infections, and one of 45 with nonstaphylococcal infections. None of the 20 patients with chronic staphylococcal osteomyelitis had positive gel-diffusion assays, even though many had had their infections for several years. The ELISA method was more sensitive than gel-diffusion in measuring teichoic acid antibodies, but was also much less specific. Teichoic acid antibodies were detected predominantly in the IgG fraction of serum. Our findings suggest that the presence and degree of antigenemia are more important than the duration of the staphylococcal infection in stimulating production of teichoic acid antibodies.
Assessment and Treatment of Suicidal Patients
Authors: Robert M.A. Hirschfeld, James M. Russell
Journal: New England Journal of Medicine (1997)

The assessment of suicidal thoughts or behavior and its management are topics relevant to all clinicians, not just mental health professionals. Up to two thirds of patients who commit suicide have seen a physician in the month before their death.15 Many patients who kill themselves do so by taking an overdose of prescribed medications, and physicians sometimes unwittingly provide the means for suicide in a single prescription.3 Few patients spontaneously report their suicidal thoughts and intentions to their physicians,4 so the clinician must be alert to signals that a patient may be at risk for suicide. Although the patient . . .
Stress and the Aching Heart
Authors: Thomas B. Graboys
Journal: New England Journal of Medicine (1984)

Every affection of the mind that is attended with either pain or pleasure, hope or fear, is the cause of an agitation whose influence extends to the heart.William Harvey, 16281 Written more than 350 years ago, Harvey's allusion to an intimate association between neural factors and the heart received some attention in anecdote and fable, yet it was not subjected to systematic direct scientific inquiry until the 1960s. Over the past 20 years we have greatly refined our approach to identifying persons at risk for cardiac death.When it was found that in most cases persons experiencing sudden cardiac . . .
Two Israeli women are barred from entering Egypt to attend breast cancer conference
Authors: J. Siegel-Itzkovich
Journal: BMJ (2009)

The foreign ministry in Jerusalem has protested against a decision by Egypt to bar two Israeli women from entering the country to take part in a conference on breast cancer.

The women—one a family therapist with expertise in serious illness and bereavement and the other a physician who has survived breast cancer—had planned to travel to Egypt on US and Canadian passports to minimise red tape. However, just before their planned departure they were told by the organisation running the conference, Susan G Komen for the Cure, that Egypt’s health minister …
Planning for the Health Care Needs of Patients With AIDS
Authors: Ann M. Hardy
Journal: JAMA (1986)

An important aspect of the epidemic of acquired immunodeficiency syndrome (AIDS) is its impact on health care provision in the United States. Because of the severe and disabling nature of AIDS, patients with the disease often require specialized medical care and psychosocial support. As AIDS becomes increasingly common, detailed information on health care needs is urgently required for long-term planning. One approach to quantifying such needs is to estimate the cost of health care for AIDS patients. Such estimates allow comparisons with costs for other diseases and are useful in determining the efficiency of various systems of health care provision. Although the cost of caring for patients with AIDS is generally recognized to be high, few attempts have been made to quantify these costs. Our earlier report<sup>1</sup>estimated health care expenditures for the first 10 000 AIDS patients in the United States and pointed out the paucity of relevant
CHANGES IN TRICUSPID ANNULAR PLANE SYSTOLIC EXCURSION PROVOKED BY EXERCISE DETERMINE THE EXERCISE CAPACITY IN PATIENTS WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION
Authors: Makoto Amaki, Hideaki Kanzaki, Akira Funada, Hiroyuki Takahama, Takuya Hasegawa, Toshihisa Anzai, Masafumi Kitakaze
Journal: Journal of the American College of Cardiology (2012)
Kidney transplants, doctors, and the media.
Authors: P McMaster
Journal: BMJ (1979)

treatment with prazosin, or prazosin plus a beta-blocker.Pape et all report similar findings in 14 patients, of whom 13 had negative ANF tests before and after prazosin and one a positive pretreatment test, which became negative after 18 weeks on prazosin.Marshall points out that his ANF findings are unlike those of systemic lupus erythematosus and that no patient had symptoms of an autoimmune illness.This is in agreement with my experience in 85 patients now treated with prazosin for periods up to five years (total patient years 255).There have never been signs or symptoms indicating an autoimmune reaction, nor have any significant laboratory abnormalities been found.
The Metabolic Syndrome: The Emperor Needs Some Consistent Clothes
Authors: Frank Vinicor, Barbara Bowman
Journal: Diabetes Care (2004)

The results of the 5th and final year, Fiscal Year 2003, are included in Table 1.We obviously did not come close to realizing this ambitious goal.In my 1998 Presidential Address, I compared the ADA to a large ship in which a new course first required a change of direction (which would occur slowly) before proceeding toward and hopefully reaching a new port.It's obvious that we have not reached that port, and realistically speaking, we probably never will.However, I would be remiss if I didn't point out the following.In each of the previous years, the increase in funding for Research Awards and Grants was much less than
Randomized trial of a GPIIb/IIIa platelet receptor blocker in refractory unstable angina. European Cooperative Study Group.
Authors: M L Simoons, M J de Boer, M J van den Brand, A J van Miltenburg, J C Hoorntje, G R Heyndrickx, L R van der Wieken, D de Bono, W Rutsch, T F Schaible
Journal: Circulation (1994)

BACKGROUND Patients with unstable angina despite intensive medical therapy, ie, refractory angina, are at high risk for developing thrombotic complications: myocardial infarction or coronary occlusion during percutaneous transluminal coronary angioplasty (PTCA). Chimeric 7E3 (c7E3) Fab is an antibody fragment that blocks the platelet glycoprotein (GP) IIb/IIIa receptor and potently inhibits platelet aggregation. METHODS AND RESULTS To evaluate whether potent platelet inhibition could reduce these complications, 60 patients with dynamic ST-T changes and recurrent pain despite intensive medical therapy were randomized to c7E3 Fab or placebo. After initial angiography had demonstrated a culprit lesion suitable for PTCA, placebo or c7E3 Fab was administered as 0.25 mg/kg bolus injection followed by 10 micrograms/min for 18 to 24 hours until 1 hour after completion of second angiography and PTCA. During study drug infusion, ischemia occurred in 9 c7E3 Fab and 16 placebo patients (P = .06). During hospital stay, 12 major events occurred in 7 placebo patients (23%), including 1 death, 4 infarcts, and 7 urgent interventions. In the c7E3 Fab group, only 1 event (an infarct) occurred (3%, P = .03). Angiography showed improved TIMI flow in 4 placebo and 6 c7E3 Fab patients and worsening of flow in 3 placebo patients but in none of the c7E3 Fab patients. Quantitative analysis showed significant improvement of the lesion in the patients treated with c7E3 Fab, which was not observed in the placebo group, although the difference between the two treatment groups was not significant. Measurement of platelet function and bleeding time demonstrated &gt; 90% blockade of GPIIb/IIIa receptors, &gt; 90% reduction of ex vivo platelet aggregation to ADP, and a significantly prolonged bleeding time during c7E3 Fab infusion, without excess bleeding. CONCLUSIONS Combined therapy with c7E3 Fab, heparin, and aspirin appears safe. These pilot study results support the concept that effective blockade of the platelet GPIIb/IIIa receptors can reduce myocardial infarction and facilitate PTCA in patients with refractory unstable angina.
Serendipitous Lymph Node Visualization During Bone Imaging
Authors: FRANK VIERAS
Journal: Clinical Nuclear Medicine (1986)

Lymph node accumulation of Tc-99m MDP was noted incidentally during the performance of bone imaging in a young male patient who had no clinical evidence of lymphatic abnormalities. Uptake was noted in the axillary region ipsilateral to the injection site. This type of finding may be a source of erroneous interpretation, as it may potentially mimic rib lesions.
Secondary Dyslipidemia
Authors: Yaakov Henkin
Journal: JAMA (1992)

<h3>Objective.</h3> —To examine the available literature on commonly prescribed drugs and their effects on blood lipid and lipoprotein levels. <h3>Data Sources.</h3> —The review was based on searches of English-language articles from 1975 to 1990 by Medlars II and MEDLINE programs, the<i>Index Medicus</i>for 1980 to 1990, and references from identified articles. Relevant journals published within the last 6 months were also examined. <h3>Study Selection.</h3> —More than 500 articles were identified for inclusion. Articles were selected on the basis of appropriateness of design to demonstrate significant results, determined by consensus when necessary. <h3>Data Extraction.</h3> —Studies were classified according to type (observational or interventional), length of follow-up, and type of controls. Quanitative analysis of lipid, lipoprotein, and apoprotein changes induced by drugs was computed as the percentage of change observed during the course of the study (interventional) or compared with the controls at a given time (observational). <h3>Data Synthesis.</h3> —Steroid hormones that have strong progestogenic and androgenic properties, retinoids, cyclosporine A, and phenothiazines are potentially atherogenic. Steroid hormones with dominant estrogenic properties, several anticonvulsants, biguanides, high-dose ketoconazole, and aminosalicylic acid are potentially antiatherogenic. Corticosteroids appear to elevate all the lipoprotein cholesterol levels. Oral estrogens, retinoids, and corticosteroids also can elevate triglyceride levels. Other drugs with questionable effects on lipoprotein metabolism are reviewed. <h3>Conclusion.</h3> —Although the long-term implications of drug-induced lipoprotein changes are still undefined, physicians need to consider these effects in clinical practice. (<i>JAMA</i>. 1992;267:961-968)
The Small Intestine: Its Function and Diseases
Authors: Howard M. Spiro
Journal: JAMA (1964)

The title of this book is misleading, and "Diseases of Malabsorption" would have been much more appropriate. Two hundred and eight pages are devoted to a review of physiology of the small intestine; here the reader can find up-to-date and comprehensive accounts of absorption and digestion of foodstuffs as well as nicely written chapters on the role of the gastrointestinal tract in the absorption of vitamin B<sub>12</sub>, folic acid, and iron; the section on radiology of the small intestine is particularly useful. Of the remaining 259 pages, 38 are devoted to tropical and nontropical sprue and 2 to intestinal obstruction, 40 to infectious diseases which involve the small intestine and 2 to Meckel's diverticulum, 44 to parasitic diseases affecting the small intestine and 8 to regional enteritis, 3 of these being full-page micrographs. The general physican clearly cannot read this book for guidance in the management of diseases of
Lack of hospital beds causes emergency departments to miss targets
Authors: Susan Mayor
Journal: BMJ (2007)

Doctors from more than a third of accident and emergency departments in hospitals in England said they were not reaching the government's target of dealing with patients within four hours.The main reason for this finding, from a survey published this week, was a shortage of available hospital beds, making it difficult for patients to be admitted.Only 49% of the nearly 500 members of the British Association for Emergency Medicine-all consultants and middle grade doctors-responding to the survey reported that their departments met the emergency access target for 98% of all patients to be seen, treated, admitted, or discharged within four hours.Although only 49% considered that their department actually met the emergency access target, 67% said that the figures reported by their department indicated that the target had been met.Respondents' comments on what had happened in their departments included, "Middle managers revising figures before being submitted," "Minor injury unit figures used to help achieve department's 96.9% target," and "Patients often 'moved' on the computer tracking but still kept in department to meet targets."Forty one per cent said that their depart- Lack of beds leads to missed government targetsment did not reach this target."Not enough available in-patient beds" was the main reason given for departments not meeting the emergency access target, and 88% of respondents reported it as a major contributory factor.Don MacKechnie, chairman of the BMA's emergency subcommittee and a consultant in emergency medicine at Pennine Acute Hospitals NHS Trust, said that financial problems in the NHS had meant that the availability of hospital beds for patients needing admission from accident and emergency departments was an important problem.He said, "In certain trusts, financial recovery measures have included closing beds previously used as 'safety valves' before, such as beds in rehabilitation wards.This has a knock-on effect to A&E [accident and emergency departments], with recovering patients that might have previously been moved remaining in acute beds."Mr MacKechnie said it was important that emergency access targets were seen as having broader application than simply affecting accident and emergency departments."Sometimes, other specialties forget that this is not just an A&E target.It is an emergency access target, with a responsibility from all specialties in an acute trust to ensure that the four hour target can be met."He said this meant ensuring that sufficient beds were available to admit patients from emergency departments and ensuring that doctors on call in each specialty are free to see patients in accident and emergency departments within the target of one hour after being referred.
Clara Cell Protein–positive Epithelial Cells Are Reduced in Small Airways of Asthmatics
Authors: NORIHARU SHIJUBO, YOSHIHISA ITOH, TETSUJI YAMAGUCHI, AKIHIRO IMADA, MICHIO HIRASAWA, TOSHIYUKI YAMADA, TADASHI KAWAI, SHOSAKU ABE
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Clara cell 10 kilodalton protein (CC10), the predominant product from nonciliated cells in the epithelial lining of bronchioles (Clara cells), has been shown to have immunomodulatory and anti-inflammatory activity, and may play roles in controlling inflammation in the airway. This study was designed to examine immunohistochemical expression of CC10 in epithelial cells in small airways (perimeter < 6 mm) of asthmatic and control nonsmokers who underwent lung resection because of peripheral lung carcinoma and to compare CC10-positive epithelial cell proportions with numbers of inflammatory cells in small airways of asthmatics. Significantly decreased proportions of CC10-positive epithelial cells and significantly increased numbers of T cells, activated eosinophils, and mast cells in small airways of asthmatics were found compared with those of control subjects. CC10-positive epithelial cell proportions inversely correlated with numbers of T cells and mast cells in small airways of asthmatics. Decreases of CC10-producing cells may give an accelerating cause for further aggravation of inflammatory responses in chronic asthma.
THE IMMIDIATE ANTIPLATELET EFFECT OF PRASUGREL VERSUS CLOPIDOGREL IN PATIENTS UNDERGOING PRIMARY ANGIOPLASTY FOR ST-ELEVATION MYOCARDIAL INFARCTION &amp;ndash; IMPLICATIONS FOR REPERFUSION
Authors: Roy Beigel, Paul Fefer, Noam Fink, Avishay Grupper, David Varon, Hanoch Hod, Shlomi Matetzky
Journal: Journal of the American College of Cardiology (2012)