tbuckley/cabot-search huggingface dataset:
PWE-262 Prevalence of harmful, hazardous or dependent drinking in hospital inpatients on a single day using audit questionnaire
Authors: M Ninkovic
Journal: Gut (2012)

<h3>Introduction</h3> Deaths from alcoholic liver disease have increased dramatically. Currently, 24% of UK adults are said to drink in a harmful or hazardous manner. The government strategy to combat alcohol mortality (NICE PH24)<sup>1</sup> includes widespread screening using validated questionnaires such as AUDIT (Alcohol Use Disorders Identification Test).<sup>2</sup> Previous studies in hospitals have been with selected patients &amp; and it is not clear how many patients in hospital are high risk drinkers. We performed a “snap shot” study of all inpatients at a single hospital on a single day using the AUDIT questionnaire to assess prevalence of high risk drinking and the feasibility of such widespread screening. <h3>Methods</h3> All adult inpatients on a single day at Peterborough City Hospital were asked to participate. Two consultants, a nurse specialist and 30 clinical medical students used the AUDIT questionnaire to assess patients for harmful, hazardous or dependent drinking. The AUDIT questionnaire consists of 10 questions with a maximum score of 40. A score of 0–7 indicates low risk, 8–15 indicates harmful drinking, 16–19 indicates hazardous drinking and &gt;20 indicates dependent drinking. Patients scoring &gt;8 were then offered a brief intervention. <h3>Results</h3> Of a total of 490 patients, AUDIT scores were obtained on 380 (78%); 110 (22%) could not be assessed because of confusion or illness. The age range was 17–99 years (mean 69). Scores ranged from 0/40 to 38/40. Of 380 inpatients who were assessed, 40 (10.5%) scored &gt; or equal to 8/40 indicating harmful, hazardous or dependent drinking. 1.6% (6/380) scored &gt;20 (dependent drinking), 7.4% (28/380) scored 16–19 (hazardous drinking) and 1.6% (6/380) scored 8–15 (harmful drinking). 89.5% (340/380) were low risk (score 0–7). Patients at risk (scoring 8 or above) were distributed across hospital wards and included 17% of females on the maternity ward, 13% on an orthopaedic ward and 12% on the respiratory ward. <h3>Conclusion</h3> We have demonstrated that 10.5% of adult hospital inpatients are drinking in a harmful, hazardous or dependent manner. They were scattered throughout the hospital and not in any particular speciality. This prevalence is lower than the 24% in the UK population, perhaps due to the higher age of hospital patients. 22% of patients could not be assessed on the day of the study. However, our results suggest that the AUDIT questionnaire is a useful tool to identify patients at risk of alcohol related problems and is a feasible undertaking. <h3>Competing interests</h3> None declared. <h3>References</h3> 1. <i>NICE Public Health Guidance 24:Alcohol-Use Disorders: Preventing Harmful Drinking</i>. 2010. 2. <b>Saunders JB</b>, Aasland OG, Babor TF, <i>et al.</i> Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption.11. <i>Addiction</i> 1993;<b>88</b>:791–804.
CLINICAL OBSERVATIONS ON PHENYLAMINOETHANOL SULPHATE
Authors: GEORGE PINESS
Journal: JAMA (1930)

In an effort to further our knowledge of the relationship between the chemical constitution and physiologic action of compounds related to epinephrine and ephedrine, as well as to establish the possible therapeutic uses of phenylaminoethanol sulphate we have continued our investigation of this substance. The first report on the clinical study of this substance from our laboratory<sup>1</sup>showed that its local application in the nose caused marked shrinking and paling of the mucous membrane without the irritation so frequently found when epinephrine is used. The duration and intensity of the local effect were in every way comparable to that of ephedrine. Phenylaminoethanol sulphate differs from ephedrine, however, in that it appears to be without useful therapeutic effect on the bronchi when injected subcutaneously or when taken orally. Topical application in the nose for the shrinking of swollen membranes thus appeared to be a clinically useful effect of phenylaminoethynol sulphate.
Malignant Thymoma in Myasthenia Gravis
Authors: Jay Harris Katz
Journal: New England Journal of Medicine (1953)

THE first modern clinical and pathological descriptions of the disease that was to be named myasthenia gravis1 were made by Wilks,2 Erb3 and Goldflam.4 Only a few years later, in 1901, Weigert5 first described the association of a thymic tumor with myasthenia.By 1917 Bell6 had collected 56 autopsied cases of myasthenia, with a benign tumor of the thymus in 10 and a generalized enlargement of the gland in 17 others. Thus, approximately 50 per cent of the patients had thymic abnormalities. In 1936 Norris7 reported similar figures among 80 cases collected to that date in which the thymus had . . .
Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure as Predictors of Risk for Congestive Heart Failure in the Framingham Heart Study
Authors: Agha W. Haider, Martin G. Larson, Stanley S. Franklin, Daniel Levy
Journal: Annals of Internal Medicine (2003)

Background: Although hypertension is a principal precursor of congestive heart failure (CHF), the separate relations of systolic, diastolic, and pulse pressure with risk for heart failure have not been fully elucidated. Objective: To examine the value of blood pressure predictors of heart failure. Design: Community-based inception cohort study. Setting: Framingham, Massachusetts. Patients: 2040 free-living Framingham Heart Study participants (mean age, 61 years [range, 50 to 79 years]). Measurements: The association of baseline systolic, diastolic, and pulse pressure with risk for incident CHF was examined in 894 men and 1146 women. Framingham Heart Study participants free of CHF at the baseline examination (performed from 1968 to 1973) were monitored for up to 24 years (mean, 17.4 years) for new-onset heart failure. Cox proportional-hazards models were used to adjust for age, sex, smoking, left ventricular hypertrophy, body mass index, diabetes mellitus, high-density lipoprotein cholesterol level, and heart rate; hazard ratios and 95% CIs for blood pressure variables were estimated. Results: CHF developed in 234 participants (11.8%) during the follow-up period. All three blood pressure components were related to the risk for CHF, but the relation was strongest for systolic and pulse pressure. A 1-SD (20 mm Hg) increment in systolic pressure conferred a 56% increased risk for CHF (hazard ratio, 1.56 [95% CI, 1.37 to 1.77]); similarly, a 1-SD (16 mm Hg) increment in pulse pressure conferred a 55% increased risk for CHF (hazard ratio, 1.55 [CI, 1.37 to 1.75]). These associations were unrelated to age, duration of follow-up, and initiation of treatment for hypertension during follow-up; they were also observed in patients with systolic hypertension (systolic blood pressure 140 mm Hg) at the baseline examination (hazard ratio, 1.41 [CI, 1.18 to 1.69] for pulse pressure and 1.42 [CI, 1.14 to 1.76] for systolic pressure). Conclusions: Although each component of blood pressure was associated with risk for CHF, pulse and systolic pressure conferred greater risk than diastolic pressure. Increased pulse pressure may help identify hypertensive patients at high risk for overt CHF who are candidates for aggressive blood pressure control.
X–linked spastic paraplegia (SPG1), MASA syndrome and X–linked hydrocephalus result from mutations in the L1 gene
Authors: Monique Jouet, André Rosenthal, Giles Armstrong, John MacFarlane, Roger Stevenson, Joan Paterson, Aïda Metzenberg, Victor Ionasescu, Karen Temple, Susan Kenwrick
Journal: Nature Genetics (1994)
Editor's reply to Ben-Tovim
Authors: F. Godlee
Journal: BMJ (2013)

Ben-Tovim asks whether the BMJ usually publishes articles on specific days at the request of authors.1 Yes, we do, although such requests are not common. Once a paper is accepted, we will do our best to fit in with authors’ requests for a specific publication date, whatever the reason given.

Ben-Tovim also …
On becoming 79
Authors: M. Courtenay
Journal: BMJ (2002)

Somewhere on the path of my medical education I had been told about the aches and pains of old age. I had made a conscious decision, as part of my determination to avoid ageism in my work, to ignore what I had been told in the interest of avoiding missing an important diagnosis in an elderly patient who produced vague symptoms. But, now I have entered the final year of my eighth decade, I have …
Transfusion and perforation.
Authors: S. M. Eades, R. L. Orme
Journal: BMJ (1969)

MRICAL 847patients with glandular fever almost invariably develop a rash if given ampicillin,25 and the same is true to a lesser extent for some other antibiotics.A survey of the literature shows that there has been a particularly high incidence of rashes in patients treated with ampicillin for Sabnonella infections.It has been postulated that some of the rashes may be produced by endotoxin released by rapid lysis of bacteria, though there is little evidence to support this.Many of these patients received high dosage, but we have been unable to show a significant relationship between dosage and incidence.An intensive investigation is being undertaken in an attempt to provide information on many of the unexplained features of the rash associated with ampicillin therapy.-I am, etc.,
Inflammatory cell numbers and cytokine expression in atopic dermatitis after topical pimecrolimus treatment
Authors: D. Simon, E. Vassina, S. Yousefi, L. R. Braathen, H.‐U. Simon
Journal: Allergy (2005)

Background: In several clinical trials the topical application of pimecrolimus was shown to be effective in the treatment of atopic dermatitis (AD). By targeting calcineurin‐dependent signaling pathways, pimecrolimus controls cytokine gene expression. The purpose of this study was to investigate the effect of pimecrolimus on the inflammatory infiltrate and cytokine expression pattern in AD upon topical therapy. Methods: From 10 patients with acute AD, skin biopsies as well as immunophenotype and cytokine production of peripheral blood mononuclear cells (PBMC) were examined before and 3 weeks after therapy. Results: The clinical improvement was associated with a marked regression of histopathological features. In particular, the density of the inflammatory infiltrate mostly containing lymphocytes and eosinophils declined. By double immunofluorescent staining, a reduced expression of the T helper (Th) 2 cytokines interleukin (IL)‐5, IL‐10, and IL‐13 in both CD4+ and CD8+ T cells was demonstrated after therapy. Pimecrolimus therapy was also associated with a reduced expression of the Th1 cytokine interferon (IFN)‐ γ . Interestingly, the numbers of epidermal CD1a+ dendritic cells increased following treatment. In the peripheral blood, a decrease of lymphocytes and eosinophils was noticed, but the distribution of lymphocyte subpopulations and their capacity of cytokine production did not change. Conclusions: Topical pimecrolimus exhibits anti‐inflammatory effects in AD by reducing the inflammatory cell infiltrate and cytokine expression in the dermis.
MRI of the wrist in early rheumatoid arthritis can be used to predict functional outcome at 6 years
Authors: N Benton
Journal: Annals of the Rheumatic Diseases (2004)

To determine whether magnetic resonance (MR) scans of the dominant wrist of patients with early rheumatoid arthritis (RA) can be used to predict functional outcome at 6 years' follow up.Dominant wrist MR scans were obtained in 42 patients with criteria for RA at first presentation. Patients were followed up prospectively for 6 years, and further scans obtained at 1 year (42 patients) and 6 years (31 patients). Two radiologists scored scans for synovitis, tendonitis, bone oedema, and erosions. The Stanford Health Assessment Questionnaire (HAQ) score, indicating functional outcome, and standard measures of disease activity were assessed at 0, 1, 2, and 6 years. The physical function component of the SF-36 score (PF-SF36) was also used as a functional outcome measure at 6 years.Baseline MR parameters, including bone oedema score and the total baseline MR score, were predictive of the PF-SF36 at 6 years (R2 = 0.22, p = 0.005 and R2 = 0.16, p = 0.02, respectively). The PF-SF36 score correlated strongly with the HAQ score at 6 years (rs = -0.725, p<0.0001); none of the baseline MR parameters predicted the 6 year HAQ score. The total MR score obtained at 1 year was predictive of the 6 year HAQ (R2 = 0.04, p = 0.01). Standard clinical and radiographic measures at baseline were not predictive of the 6 year PF-SF36, but when combined in a model with baseline MR oedema score, prediction increased from 0.09 to 0.23, or 23% of the 6 year variance.MR imaging of the wrist in patients with early RA can help to predict function at 6 years and could be used to plan aggressive management at an earlier stage.
Adequacy of Well-Child Care and Immunizations in US Infants Born in 1988
Authors: Henry D. Mustin
Journal: JAMA (1994)

<h3>Objective.</h3> —To determine adequacy of preventive care for US infants, including both well-child care visits and immunizations, and to identify risk factors for inadequate receipt of care. <h3>Design.</h3> —Analysis of the 1988 National Maternal and Infant Health Survey of the National Center for Health Statistics. <h3>Sample.</h3> —Nationally representative sample of all US children born in 1988. <h3>Participants.</h3> —A total of 7035 infants from a live-birth subsample who were at least 8 months of age and living with their mothers at the time of the survey. <h3>Main Outcome Measures.</h3> —Percentage of children receiving both adequate well-child visits and adequate immunizations by 8 months of age. <h3>Results.</h3> —Adequate visits were received by 82% of white infants and 75% of black infants; adequate immunizations were received by 46% and 34%, respectively. Forty-two percent of white infants and 29% of black infants received both. Sixty percent of infants who did not have adequate immunizations by 8 months of age had at least three well-baby visits. With adjustment for maternal education level, poor white children had a relative risk of 1.5 of receiving inadequate care compared with infants in families with income greater than 185% of the federal poverty level. Infants with Medicaid or other government assistance had significantly lower levels of adequate care than did infants with private insurance. <h3>Conclusions.</h3> —This study demonstrates a wide gap between actual immunization coverage levels and recommended levels among US infants born in 1988. Public health agencies, Medicaid programs, and primary care providers should explore ways to take better advantage of well-child visits that are already occurring to achieve appropriate levels of immunization coverage. (<i>JAMA</i>. 1994;272:1111-1115)
When should a specialist retire?
Authors: J. H. Baron
Journal: BMJ (1998)

In 1844 an editorial in the Lancet (1844;i:486-90), presumably by Thomas Wakley, excoriated the eminent William Prout as a man who had outlived his reputation and exerted a stultifying influence on progress in his field:

“[H]is main researches have been superseded by others …. [He] has retained in the text of his last edition his own account of the process of digestion without taking proper cognisance of the digestive principle pepsin …. [His] pathological notions … have the appearance of closet speculations, and are diametrically opposed to the opinions of the soundest and most experienced men of the day …. [He has] total disregard of numerical and statistical details … [and offers] hypotheses which are unsubstantiated either by facts or arguments …. Dr Prout's name and authority exercise an influence that is detrimental to the cause of science in this country …. Time was when our schools stood foremost in the ranks for originality and discovery, but that time seems to have passed away …. The fault …
A Physiological Factor in Haemoglobinometry
Authors: E. F. McCarthy
Journal: BMJ (1943)

are more likely to occur in the presence of some active infec- tion-of which Vincent's angina constitutes an example. ConclusionsVincent's infection sometimes develops in patients uinder- going antisyphilitic treatment with intravenous arsenicals.The use of intravenous arsenicals in the treatment of Vincent's infection is unsound, both on theoretical and on clinical grounds, particularly since the condition responds readily to other less expensive and less dangerous drugs.I am indebted to Flight Lieut.S. C. Holms, R.A.F.V.R.
Cardiopulmonary Resuscitation — Strengthening the Links in the Chain of Survival
Authors: Gordon A. Ewy
Journal: New England Journal of Medicine (2000)

The major determinants of survival after witnessed out-of-hospital cardiac arrest due to ventricular fibrillation include whether a bystander initiates cardiopulmonary resuscitation (CPR) and how quickly defibrillation is accomplished.The now-classic observations of Eisenberg et al. were that among patients with out-of-hospital cardiac arrest due to ventricular fibrillation, 43 percent survived to leave the hospital if CPR was initiated by a bystander within four minutes and if definitive therapy was delivered within eight minutes.1 Survival decreased to less than 7 percent if basic CPR was not initiated until 8 minutes, and no patient survived after 16 minutes of untreated ventricular fibrillation. . . .
HTLV-I, BRAIN ABNORMALITIES ON MAGNETIC RESONANCE IMAGING, AND RELATION WITH MULTIPLE SCLEROSIS
Authors: E. Tournier-Lasserve, O. Gout, A. Gessain, M.T. Iba-Zizen, O. Lyon-Caen, F. Lhermitte, G. De-Thé
Journal: The Lancet (1987)
Clinical and molecular characterization of 6 patients affected by severe deficiency of coagulation factor V: broadening of the mutational spectrum of factor V gene and in vitro analysis of the newly identified missense mutations
Authors: Maria Claudia Montefusco, Stefano Duga, Rosanna Asselta, Massimo Malcovati, Flora Peyvandi, Elena Santagostino, Pier Mannuccio Mannucci, Maria Luisa Tenchini
Journal: Blood (2003)
Pulmonary Mucormycosis in a Diabetic Patient with HIV
Authors: Marie-Laure Virally, Jean-Pierre Riveline, Jerome Virally, Pierre Chevojon, Jean-François Regnard, Abderrahmane Belmekki, Alain Devidas
Journal: Diabetes Care (2002)

Comment -I interpret these results to support the recommendation of both the American Kidney Foundation and the American Diabetes Association that ACR can be used instead of a timed collection.Timed collections, 24 h or otherwise, are very inconvenient and often not collected accurately.Since albumin excretion is highly variable from day to day (up to 25%), a repeat ACR to fulfill the criterion of two of three positive values within a 3-to 6-month period as recommended for the diagnosis of microalbuminuria would very likely have reduced the false-positive rate of 6%.Mogensen CE: Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes.
Changes of the levels of secretory type II phospholipase A 2 in patients with coronary artery disease undergoing percutaneous coronary intervention
Authors: Ping-Yen Liu, Yi-Heng Li, Wei-Chuan Tsai, Ting-Hsing Chao, Shi-Hong Chan, Liang-Miin Tsai, Jyh-Hong Chen
Journal: Journal of the American College of Cardiology (2002)
Double-Blind Evaluation of a New Treatment for Ménière's Syndrome
Authors: Joseph C. Elia
Journal: JAMA (1966)

WHEN VERTIGO, associated with Ménière's syndrome, becomes intractable and incapacitating, the patient becomes a candidate for surgery. This is not a pleasant outlook for the patient, nor for the treating physician. As a consequence, there has been an incessant but yet unrewarding search for a satisfactory medical treatment. Williams<sup>1</sup>recently reported: Neither the definition, the diagnosis nor the dysfunction of Ménière's disease is much clearer now than when Ménière first described the condition in 1861.... On the basis of recently acquired information, we may define Ménière's disease as a disorder of a predisposed stria vascularis, possibly in response to a hypothalamic stimulus, with the local synthesis of toxic amounts of histamine and possibly of norepinephrine, producing in the stria vascularis the picture of the slow stage of shock, increased hydrodynamic pressure in the endolymphatic system, loss of hearing, and, secondarily, attacks of vertigo, nausea and vomiting. In a later
[4] 72 WEEK DATA OF THE HIDIT-1 TRIAL: A MULTICENTER RANDOMISED STUDY COMPARING PEGINTERFERON α-2a PLUS ADEFOVIR VS. PEGINTERFERON α-2a PLUS PLACEBO VS. ADEFOVIR IN CHRONIC DELTA HEPATITIS
Authors: H. Wedemever, C. Yurdaydin, G. Dalekos, A. Erhardt, Y. Cakaloglu, H. Degertekin, S. Gurel, S. Zeuzem, T. Bock, K. Zachou, H. Bozkaya, U. Drebber, S. Meyer, H.P. Dienes, M.P. Manns
Journal: Journal of Hepatology (2007)
SPECT IMAGING WITH I-123 ISOPROPYL AMPHETAMINE IN ASYMPTOMATIC HIV SEROPOSITIVE PERSONS
Authors: N. D. LaFrance, G. Pearlson, F. Schaerf, J. McArthur, M. J. Bascom, A. J. Kumar, J. Turek, P. Cole, J. Chen, H. N. Wagner
Journal: Clinical Nuclear Medicine (1988)

HIV encephalopathy (HIVE) is at times the first manifestation of AIDS in HIV+ patients. We studied 13 HIV+, patients by SPECT 30 minutes after 6 mCi of IMP was administered IV. Seven of 13 patients had HIVE while 6/13 were asymptomatic. Dementia was defined by a Trails B and Mini-Mental State evaluation. Seven patients had a single study; 5 patients had 2 studies over a period of 5 ± 2.5 months; 1 patient had a third SPECT study 7 months after the second; and 5 normal controls were studied once. Scans were assessed quantitatively by placing ROIs (3x3 pixels) over standardized cortical and subcortical regions on the axial SPECT slice through the basal ganglia at the level of the pineal and foramen of Monro. Visual inspection of scans compared to controls revealed scattered patchy cortical asymmetries. Quantitatively, subcortical evaluation showed that 5/7 HIVE and 1/6HIV+ patients had values 2SD below normal and 1/7 HIVE and 2/6 HIV+ (non-HIVE) had subcortical values 2SD above normal. 9/13 HIV+ had an asymmetry index more than 2SD from the normal mean. We conclude: these I-123-IMP studies are in agreement with PET studies of Rottenberg et al and HMPAO SPECT data of Ell et al. However, we detected significant changes in 67% of seropositive individuals without HIVE which may indicate that SPECT is an early predictor of dementia in AIDS.
Improving vaccine storage in general practice refrigerators
Authors: A. Jeremijenko, H. Kelly, B. Sibthorpe, R. Attewell
Journal: BMJ (1996)

Current leg ulcer care is expensive and ineffective * The introduction of community leg ulcer clinics improved care and resulted in lower costs than the traditional approach that the clinics replaced * Planned and coordinated programmes of care can reduce costs substantially while improving healing rates * Community units and general practitioners should be encouraged to seek alternatives to the standard care for leg ulcers Improving vaccine storage in general practice refrigerators