tbuckley/cabot-search huggingface dataset:
Outcome of planned home births in an inner city practice.
Authors: C Ford, S Iliffe, O Franklin
Journal: BMJ (1991)

OBJECTIVE--To assess the outcome of pregnancy for women booking for home births in an inner London practice between 1977 and 1989. DESIGN--Retrospective review of practice obstetric records. SETTING--A general practice in London. SUBJECTS--285 women registered with the practice or referred by neighbouring general practitioners or local community midwives. MAIN OUTCOME MEASURES--Place of birth and number of cases transferred to specialist care before, during, and after labour. RESULTS--Of 285 women who booked for home births, eight left the practice area before the onset of labour, giving a study population of 277 women. Six had spontaneous abortions, 26 were transferred to specialist care during pregnancy, another 26 were transferred during labour, and four were transferred in the postpartum period. 215 women (77.6%, 95% confidence interval 72.7 to 82.5) had normal births at home without needing specialist help. Transfer to specialist care during pregnancy was not significantly related to parity, but nulliparous women were significantly more likely to require transfer during labour (p = 0.00002). Postnatal complications requiring specialist attention were uncommon among mothers delivered at home (four cases) and rare among their babies (three cases). CONCLUSIONS--Birth at home is practical and safe for a self selected population of multiparous women, but nulliparous women are more likely to require transfer to hospital during labour because of delay in labour. Close cooperation between the general practitioner and both community midwives and hospital obstetricians is important in minimising the risks of trial of labour at home.
Predicting Bacteremia in Hospitalized Patients
Authors: David W. Bates
Journal: Annals of Internal Medicine (1990)

Objective: To develop and validate a model for the prediction of bacteremia in hospitalized patients, and to identify subgroups of patients with a very low likelihood of bacteremia in whom a positive blood culture has a low positive predictive value. Design: Prospective cohort study with clinical data on 1516 episodes collected from a random sample of all patients who had blood cultures done at one institution. Setting: Urban, tertiary care hospital. Patients: Derivation set: 1007 blood culture episodes sampled from all blood cultures done on patients at Brigham and Women's Hospital between October 1988 and February 1989. Validation set: 509 episodes, May 1989 to June 1989. The unit of evaluation was the episode, defined as a 48-hour period beginning after a blood culture was drawn. Measurements and Main Results: True- and false-positive rates of blood cultures in the derivation set as assessed by independent reviewers were 7% (74 of 1007) and 8% (81 of 1007), respectively. Independent multivariate predictors of true bacteremia were temperature of 38.3 °C or higher, presence of a rapidly (< 1 month) or ultimately (< 5 years) fatal disease; shaking chills; intravenous drug abuse; acute abdomen on examination; and major comorbidity. In the low-risk group, defined by absence of these predictors, the misclassification rate of the model in the derivation set was 1% (4 of 303), and a positive blood culture had a positive predictive value of only 14% for true bacteremia. The model also identified a high-risk subset in which 16% (41 of 264) of episodes represented true bacteremia. The model was prospectively validated in 509 additional episodes, and the misclassification rate in the low-risk group was 2% (3 of 155). Interventions: None. Conclusion: These findings provide a means of stratifying hospitalized patients according to their risk for bacteremia. If prospectively validated in other settings, this model may be helpful when deciding whether or not to do blood cultures or start antibiotic therapy and, when evaluating a positive blood culture, to determine whether or not it is a true-positive.
The serological abnormalities of idiopathic myocardial disease
Authors: J. A. Robinson, H. G. Grieble, T. O. Anderson
Journal: Cardiovascular Research (1970)

Seventy-three patients with idiopathic myocardial disease were investigated for markers of immunopathology. Abnormalities included hypoproteinaemia (13%), hypergammaglobulinaemia (43%), elevated complement (78%), rheumatoid factor (44%), anti-tissue (16%) and anti-striated muscle (20%) antibodies, biological false positive tests for syphilis: transient reactors 44% chronic 13%. The results were interpreted as immunological consequences of myocardial destruction rather than causative phenomena.
Phylogeography and Origin of Indian Domestic Goats
Authors: M. B. Joshi
Journal: Molecular Biology and Evolution (2003)

The Indian subcontinent contains 20 well-characterized goat breeds, which vary in their genetic potential for the production of milk, meat, and fibre; disease resistance; heat tolerance; and fecundity. Indian goats make up 20% of the world's goat population, but there has been no extensive study of these economically important animals. Therefore, we have undertaken the present investigation of 363 goats belonging to 10 different breeds from different geographic regions of India using mtDNA sequence data from the HVRI region. We find evidence for population structure and novel lineages in Indian goats and cannot reconcile the genetic diversity found within the major lineage with domestication starting 10,000 years ago from a single mtDNA ancestor. Thus, we propose a more complex origin for domestic goats.
A Prospective Randomized Study Comparing Monopolar and Bipolar Transurethral Resection of Prostate Using Transurethral Resection in Saline (TURIS) System
Authors: Henry S.S. Ho, Sidney K.H. Yip, Kok B. Lim, Stephanie Fook, Keong T. Foo, Christopher W.S. Cheng
Journal: European Urology (2007)
High result in prostate specific antigen test: Ten minutes is not enough to deal with the PSA question
Authors: J. N Rao
Journal: BMJ (2003)

Editor—The paper by Mokete et al with its electronic responses raises more questions than it answers.1,2 Perhaps the biggest question is whether a consultation on whether to do a prostate specific antigen (PSA) test is possible in 10 minutes, never mind advising what to do if the result is raised.

The material on the web sites of the Department of Health and national screening committee is extensive. It would take far longer than 10 minutes to read the prostate cancer and PSA fact sheets, let alone go through the questions that men faced with all this information might raise.

The field is hopelessly muddled: there's simply too much conflicting information and advice out there.

Firstly, the benefits of opportunistic PSA testing are yet to be proved.

Secondly, no one should be advised to have a PSA test without a cooling off period to consider all the issues, if necessary on more than one consultation.

Thirdly, when a PSA test result is marginally raised no one should pretend that the way forward is simple or straightforward. There are many choices: from ignoring the test result (difficult to do) to repeating it (the obvious choice, but again, only after the patient has had the opportunity and the time to consider all the implications); from referral to a urologist (who will not have ready answers either) to guided biopsy.

No one knows what the best thing is to do. Perhaps the only conclusion to draw is that the article should have been titled “Not a 10-minute consultation.”
P183 Comparison of patient satisfaction between endobronchial ultrasound and flexible bronchoscopy performed under conscious sedation: a prospective study
Authors: S. Huq, C. Smyth, S. Kazmi, T. Giles, M. Walshaw, S. Binukrishnan, K. Mohan
Journal: Thorax (2011)

<h3>Background</h3> Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is increasingly performed by respiratory physicians across the UK. Although patient satisfaction with flexible bronchoscopy (FB) is high, there are no studies comparing patient satisfaction with FB vs EBUS performed under conscious sedation. <h3>Methods</h3> In this prospective study, patients completed a questionnaire 2 h post-procedure when they were fully awake as determined by the modified Aldrete score. The questionnaire consisted of a 4-point Likert scale to record the degree of discomfort and a 5-point scale to record the overall satisfaction and willingness to return for the procedure. Both EBUS and FB were performed using topical lignocaine and intravenous midazolam. EBUS was performed by a consultant physician, whereas FB was performed by a consultant physician or a specialty registrar. <h3>Results</h3> 52 consecutive patients (mean age 65) undergoing EBUS and 35 patients (mean age 66) undergoing FB completed the study. Although the mean dose of intravenous midazolam used in the EBUS group was higher (3.16 mg vs 2.52 mg; p&lt;0.01), the level of sedation (determined by sedation score of 0-unresponsive to 6-agitated) pre-scope insertion was similar in both groups. The mean dose of topical lignocaine (excluding oropharyngeal lignocaine) was also similar in both groups. The duration of procedure with EBUS was longer compared to FB (21.25 min vs 12.09 min; p&lt;0.001). Despite this, there were no significant differences in the reported patient discomfort with anaesthetic throat spray, transtracheal lignocaine injection or scope insertion. Similarly, there were no significant differences in the reported incidence of cough, dyspnoea, throat pain, chest pain, feeling of suffocation and overall tolerance of the procedure. The overall satisfaction for the procedure was 95% in the EBUS group and 89% in the FB group, while 92% and 86% respectively were willing to have the procedure again if needed. EBUS was diagnostic in 96% (mean lymph node size 1.6 cm) and there were no complications. <h3>Conclusion</h3> Patient satisfaction with EBUS-TBNA under conscious sedation is high. As EBUS services continue to expand, physicians can perform this under conscious sedation with similar patient satisfaction level as experienced with FB.
Violence against Women: A Physician's Guide to Identification and Management
Authors: Patricia R. Salber
Journal: Annals of Internal Medicine (2004)

Medical Writings: Book Notes6 January 2004Violence against Women: A Physician's Guide to Identification and ManagementPatricia R. Salber, MD, MBAPatricia R. Salber, MD, MBAFrom Blue Shield of California and Physicians for a Violence-free, Society, San Francisco, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-1-200401060-00042 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Liebschutz JM, Frayne SM, Saxe SM, eds. 368 pages. Philadelphia: American Coll of Physicians; 2003. $38.00. ISBN 1930513119. Order phone 215-351-2600.Field of medicine: General internal medicine.Format: Softcover book.Audience: General internists and other primary care providers.Purpose: To provide primary care providers with practical information about how to identify and respond to the clinical impact of violence against women in everyday practice.Content: The book is divided into 3 parts: clinical issues, special considerations, and clinical vignettes. The first section defines risk factors, clinical presentations, and medical management of female victims of violence, particularly intimate-partner violence and sexual ... Author, Article, and Disclosure InformationAffiliations: From Blue Shield of California and Physicians for a Violence-free, Society, San Francisco, California. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 January 2004Volume 140, Issue 1Page: 76KeywordsAssaultDomestic violenceHealth careHealth care providersNative American peoplePregnancyPsychiatry and mental healthSoftware toolsStrokeSurvival analysis ePublished: 6 January 2004 Issue Published: 6 January 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality
Authors: Mohamed L. Sorror, Paul J. Martin, Rainer F. Storb, Smita Bhatia, Richard T. Maziarz, Michael A. Pulsipher, Michael B. Maris, Christopher Davis, H. Joachim Deeg, Stephanie J. Lee, David G. Maloney, Brenda M. Sandmaier, Frederick R. Appelbaum, Theodore A. Gooley
Journal: Blood (2014)
TREATMENT OF ACUTE CORYZA BY AUTOGENOUS VACCINES
Authors: L. Hoyle
Journal: BMJ (1933)

~~~~~~AND ~~~~~MEDI3CAL JOURNALintolerance to plasmoquine has occurred, nor is it expected to occur with the dosage prescribed; and none of The toxic symptoms occasionally seen with that drug (for example, cyanosis, abdominal pains) has been noted.The treat- TABLE I.-Cases Shown in Tabtlar Form h a ;.,tm H a 3 so Remarks 0 0~~~~~~~~~( E. C.... 12/29 Two Benign None 4/33 Mixed infection con- previotis and tracted. in Venezuela attacks subtertian' five months previously H. P.... 1/30 Many Benign 12130 7/31 Contracted in Ceylon attacks eighteen months pre- vionisly.Had a " ctre" in European.tropical hospital in July, 1929.
Health and Social Care Bill
Authors: R. Coombes
Journal: BMJ (2011)

The Health and Social Care Bill—all 281 clauses of it—was introduced into Parliament last week. The draft legislation for England is largely the vision of health secretary Andrew Lansley. Health unions fear that the reforms, which hand general practitioners control of over 80% of the NHS budget, are a cloak for privatisation.

Lansley’s insistence on a breakneck speed for his reforms could be his downfall, say critics. By April 2013, the 152 primary care trusts will be abolished and all general practitioners required to join a commissioning consortium. The pace is breathtaking. One scenario is that this wholesale transition won’t be possible. Nuffield Trust director Jennifer Dixon believes that “in areas where there are the weakest consortia, PCTs will remain in existence for much longer than 2013.”

The upfront cost of putting reforms in place—to be largely incurred between this year and 2013—is estimated to be £1.4bn (€1.6bn, $2.2bn). This includes redundancy costs of £1bn. The remainder of the cost will be run up by transferring IT systems and staff from PCT to consortium premises, and start-up costs for consortiums. The Department of Health expects 50-70% of staff will transfer from PCTs/strategic health authorities to new structures, including consortiums.

Lansley is hoping for a reduction of a third in administration spending. By 2014-5, the NHS in England (excluding the acute sector) is expected to be spending £1.7bn less …
Research and Treatment in Psychiatry
Authors: E. K. Ledermann
Journal: BMJ (1960)

Limited health literacy is common in the United States and associates with poor clinical outcomes. Little is known about the effect of health literacy in patients with advanced kidney disease. In this prospective cohort study we describe the prevalence of limited health literacy and examine its association with the risk for mortality in hemodialysis patients. We enrolled 480 incident chronic hemodialysis patients from 77 dialysis clinics between 2005 and 2007 and followed them until April 2008. Measured using the Rapid Estimate of Adult Literacy in Medicine, 32% of patients had limited (&lt;9th grade reading level) and 68% had adequate health literacy (≥9th grade reading level). Limited health literacy was more likely in patients who were male and non-white and who had fewer years of education. Compared with adequate literacy, limited health literacy associated with a higher risk for death (HR 1.54; 95% CI 1.01 to 2.36) even after adjustment for age, sex, race, and diabetes. In summary, limited health literacy is common and associates with higher mortality in chronic hemodialysis patients. Addressing health literacy may improve survival for these patients.
Synchrotron Radiation Imaging for Advancing Our Understanding of Cardiovascular Function
Authors: Mikiyasu Shirai, Daryl O. Schwenke, Hirotsugu Tsuchimochi, Keiji Umetani, Naoto Yagi, James T. Pearson
Journal: Circulation Research (2013)

Synchrotron radiation (SR) is increasingly being used for micro-level and nano-level functional imaging in in vivo animal experiments. This review focuses on the methodology that enables repeated and regional assessment of vessel internal diameter and flow in the resistance vessels of different organ systems. In particular, SR absorption microangiography approaches offer unique opportunities for real-time in vivo vascular imaging in small animals, even during dynamic motion of the heart and lungs. We also describe recent progress in the translation of multiple phase-contrast imaging techniques from ex vivo to in vivo small-animal studies. Furthermore, we also review the utility of SR for multiple pinpoint (dimensions 0.2×0.2 mm) assessments of myocardial function at the cross-bridge level in different regions of the heart using small-angle X-ray scattering, resulting from increases in SR flux at modern facilities. Finally, we present cases for the use of complementary SR approaches to study cardiovascular function, particularly the pathological changes associated with disease using small-animal models.
David Ronald (“Ronnie”) Kilgour
Authors: Hugh Kilgour, Pharic Gillibrand
Journal: BMJ (2006)

​FormerFormer consultant obstetrician and gynaecologist Southampton University Hospitals (b 1913; q Edinburgh 1936; FRCS Ed, FRCOG), d 22 March 2006.




Figure 1




David Ronald (“Ronnie”) Kilgour was the eldest of three medical brothers, each serving in a different armed service. Ronnie was posted with the navy to the Far East, narrowly escaping becoming a prisoner of war when Singapore fell. After the war Ronnie had appointments at St Mary's Hospital in London and was senior registrar at Jessops Hospital, Sheffield. He was a skilful and well organised surgeon, taking great interest in his juniors' surgical training as consultant in Southampton. He retired in 1978. Predeceased by four months by his wife, he leaves two children.
THE ACCESSORY LOBE OF THE AZYGOS VEIN
Authors: H. P. Nelson, G. Simon
Journal: BMJ (1931)

tion of forceps.It seems, however, that many obstetric surgeons, imbued with what inay be called the " furor operativus," make the mere diagnosis of contracted pelvis a reason for the performrance of this operation, apart altogether from other considerations.If cases were carefully considered on the lines given above, there is very little doubt that many unnecessary Caesarean sections would be avoided.If I have gone rather minutely into detail, my excuse is that the more I thinik over the problem of maternial mortality the more convinced I become that it is only by close attention to every detail, anid by co-operation between all the members of the obstetric team, and especially between general practitioners and midwives, that we slhall make any real impression upon the ntimber of women who are every year dying preventable deaths.
Effects of prolonged transesophageal echocardiographic imaging and probe manipulation on the esophagus—An echocardiographic-pathologic study
Authors: John P. O’Shea, James F. Southern, Michael N. D’Ambra, Cynthia Magro, J. Luis Guerrero, Jane E. Marshall, Gus V. Vlahakes, Robert A. Levine, Arthur E. Weyman
Journal: Journal of the American College of Cardiology (1991)
Volvulus of the Cecum and Ascending Colon
Authors: Edward L. Young, Harvey R. Morrison, Walter E. Wilson
Journal: New England Journal of Medicine (1947)

IT IS the purpose of this paper to present 7 cases of volvulus of the cecum and ascending colon and to discuss the preoperative diagnosis of this condition, with emphasis on roentgenologic findings, and the proper surgical treatment.The problem of volvulus of the cecum is not frequent, and yet one of us (E.L.Y.) has operated on 3 cases in the last four years. The incidence in North America is relatively low. At the Massachusetts General Hospital over a period of fifty-seven years it was 1.15 per cent (6 cases) in 520 cases of acute intestinal obstruction exclusive of those . . .
Review: New oral anticoagulants increase GI bleeding in venous thrombosis and ACS
Authors: Thomas Vanassche, Stuart J. Connolly, John W. Eikelboom
Journal: Annals of Internal Medicine (2014)

Source Citation Holster IL, Valkhoff VE, Kuipers EJ, Tjwa ET. New oral anticoagulants increase risk for gastrointestinal bleeding: a systematic review and meta-analysis. Gastroenterology. 2013;145:105-12.e15. 23470618
Endotoxemia produces coma and brain swelling in bile duct ligated rats
Authors: Gavin Wright, Nathan A. Davies, Debbie L. Shawcross, Stephen J. Hodges, Claudia Zwingmann, Heather F. Brooks, Ali R. Mani, David Harry, Vanessa Stadlbauer, Zheng Zou, Roger Williams, Ceri Davies, Kevin P. Moore, Rajiv Jalan
Journal: Hepatology (2007)

This study explores the hypothesis that the inflammatory response induced by administration of lipopolysaccharide (LPS) exacerbates brain edema in cirrhotic rats; and if so whether this is associated with altered brain metabolism of ammonia or anatomical disturbance of the blood-brain barrier. Adult Sprague-Dawley rats 4 weeks after bile duct ligation (BDL)/Sham-operation, or naïve rats fed a hyperammonemic diet (HD), were injected with LPS (0.5 mg/kg, intraperitoneally) or saline, and killed 3 hours later. LPS administration increased brain water in HD, BDL, and sham-operated groups significantly (P < 0.05), but this was associated with progression to pre-coma stages only in BDL rats. LPS induced cytotoxic brain swelling and maintained anatomical integrity of the blood-brain barrier. Plasma/brain ammonia levels were higher in HD and BDL rats than in sham-operated controls and did not change with LPS administration. Brain glutamine/myoinositol ratio was increased in the HD group but reduced in the BDL animals. There was a background pro-inflammatory cytokine response in the brains of cirrhotic rats, and plasma/brain tumor necrosis factor alpha (TNF-alpha) and IL-6 significantly increased in LPS-treated animals. Plasma nitrite/nitrate levels increased significantly in LPS groups compared with non-LPS controls; however, frontal cortex nitrotyrosine levels only increased in the BDL + LPS rats (P < 0.005 versus BDL controls).Injection of LPS into cirrhotic rats induces pre-coma and exacerbates cytotoxic edema because of the synergistic effect of hyperammonemia and the induced inflammatory response. Although the exact mechanism of how hyperammonemia and LPS facilitate cytotoxic edema and pre-coma in cirrhosis is not clear, our data support an important role for the nitrosation of brain proteins.