tbuckley/cabot-search huggingface dataset:
The visual analogue scale in the assessment of grip strength.
Authors: W W Downie, P A Leatham, V M Rhind, M E Pickup, V Wright
Journal: Annals of the Rheumatic Diseases (1978)

The accuracy of information derived from a visual analogue scale has been assessed by comparing the measured grip strength of 100 subjects against their estimate of grip strength scored on a visual analogue scale. There was relatively poor correlation between the measured and assessed values, suggesting that similar inaccuracies may occur when the scales are used to assess subjective phenomena.
Weaning From Mechanical Cardiac Support in Patients With Idiopathic Dilated Cardiomyopathy
Authors: Johannes Müller, Gerd Wallukat, Yu-Guo Weng, Michael Dandel, Susanne Spiegelsberger, Sabine Semrau, Kersten Brandes, Vassilis Theodoridis, Matthias Loebe, Rudolf Meyer, Roland Hetzer
Journal: Circulation (1997)

Background Implantation of mechanical cardiac support systems (MCSS) in patients with idiopathic dilated cardiomyopathy (IDC) may improve cardiac function and allow explantation of the device. We report of long-term effects of ventricular unloading on cardiac function, humoral anti-β1-adrenoceptor autoantibodies (A-β 1 -AABs), and myocardial fibrosis. Methods and Results Seventeen patients in New York Heart Association functional class IV with nonischemic IDC received MCSS. All had a cardiac index of &lt;1.6 L · min −1 · m −2 of body surface area, a left ventricular ejection fraction (LVEF) of &lt;16%, and a left ventricular internal diameter in diastole (LVIDd) of &gt;68 mm and tested positive for A-β 1 -AABs. Echocardiographic evaluation, serum tests for A-β 1 -AABs, and histological assessment of myocardial fibrosis were performed before and after MCSS implantation. The mean support duration was 230±201 days. Six patients died, four were transplanted, and two are still on MCSS. Five patients with significant cardiac recovery (mean LVIDd, 54±2.3 mm; LVEF, 47±3.7%) were weaned after 160 to 794 days and are now device free for 51 to 592 days. A-β 1 -AABs disappeared gradually during MCSS without increase after weaning; cardiac function and volume density of fibrosis remained normal. Nine patients’ cardiac function hardly improved during ventricular unloading. Conclusions Cardiac function can be normalized in selected patients with end-stage IDC by MCSS. The degree of preoperative myocardial fibrosis may be an indicator for outcome; A-β 1 -AABs can be used to monitor myocyte recovery. Weaning from MCSS offers an alternative to cardiac transplantation in certain patients.
ENLARGEMENT OF THE HEART WITHOUT VALVULAR DISEASE—WITH SPECIAL REFERENCE TO TREATMENT.Read at the meeting of the Mississippi Valley Medical Association, held at Hot Springs, Ark., Nov. 20-23, 1894.
Authors: KOBEB.T H. BABCOCK
Journal: JAMA (1894)

If any excuse be needed for the presentation of this paper, it is found in the frequency with which individuals have consulted me of late, suffering from enlargement of the heart without valvular lesion. In looking over my record of cases for the twelve months ending Nov. 1, 1894,.I find, that of the cases of heart disease there entered, 15.4 per cent, are under the diagnosis of idiopathic enlargement of the heart. Although open to the objection of vagueness and implied ignorance of the nature of the disease this term is, nevertheless, employed by Fraentzel because it embraces in concise form all those cases of hypertrophy and dilatation of the heart, unassociated with chronic endocarditis. On account of its conciseness, therefore, I shall make use of Fraentzel's term interchangeably, with that stated in the title of this paper. Hypertrophy and dilatation are combined, the former predominating so long as compensation
Qualitative Issues in Developing Educational Diagnostic Instruments and Assessment Procedures for Diabetic Patients
Authors: Richard A Windsor, Jeffrey Roseman, George Gartseff, Katharine A Kirk
Journal: Diabetes Care (1981)

With one exception, psychometric analyses of the quality of instrumentation and educational assessment procedures for diabetic patients have not been reported in the literature. Following an extensive internal review process, a pilot test of 56 diabetic patients found that the newly developed instrument had a high degree of internal consistency for the major indexes, 0.89 and 0.85, respectively. An item analysis found individual questions to be of an acceptable quality. An analysis of interrater reliability of patient assessment procedures produced an r = 0.93. Some support for content and concurrent validity was noted. Using an external review by an expert panel, a revised instrument and protocol was used to conduct a formal field test of 100 diabetic patients. Levels of internal consistency similar to the pilot, 0.87 adn 0.86, were found. An item analysis produced similar positive results. While some support for concurrent validity of the data was found, little support for discriminant validity was evident. The instrument and assessment procedures need to undergo more extensive and rigorous examination of its psychometric characteristics, particularly stability and predictive validity.
Inhaled frusemide and exercise induced asthma: evidence of a role for inhibitory prostanoids.
Authors: I D Pavord, A Wisniewski, A E Tattersfield
Journal: Thorax (1992)

BACKGROUND: Inhaled frusemide protects subjects with asthma against a wide range of bronchoconstrictor challenges, including allergen, exercise and inhaled sodium metabisulphite. An investigation was designed to determine whether this protection is related to the production of inhibitory prostaglandins, such as prostaglandin E2 (PGE2), by studying the effect of the cyclooxygenase inhibitor indomethacin on the protection afforded by inhaled frusemide against exercise induced asthma. METHODS: In a double blind crossover study 10 subjects with mild asthma were pretreated with indomethacin (50 mg thrice daily) or placebo capsules for three days; they then inhaled frusemide (40 mg) or placebo 10 minutes before an exercise test previously shown to cause a 20-30% fall in forced expiratory volume in one second (FEV1). RESULTS: After inhalation of placebo exercise caused a similar maximum fall in FEV1 whether pretreatment was with placebo (26%) or indomethacin (25.2%). After inhalation of frusemide the maximum fall in FEV1 was reduced to 14.3% after placebo pretreatment and to 21.8% after indomethacin pretreatment; the difference between placebo and indomethacin pretreatment was significant (mean difference 7.5%, 95% limits 0.6%, 14.4%). The inhibitory effect of frusemide on the response to exercise, assessed as change in FEV1 over 30 minutes, was significantly greater with placebo (62%) than indomethacin (13%) pretreatment. CONCLUSION: These findings support a role for inhibitory prostanoids, such as PGE2, in the beneficial effects of frusemide as a protection against exercise induced asthma.
Beta-adrenergic contractile reserve as predictor of the clinical outcome in patients with idiopathic dilated cardiomyopathy
Authors: Jean L Dubois-Randé, Pascal Merlet, Christophe Benvenuti, Luc Hittinger, Anne M Duval, David Lellouche, Daniel Loisance, Alain Castaigne
Journal: Journal of the American College of Cardiology (1991)
Enophthalmos Is Not Present in Horner Syndrome
Authors: Robert Daroff
Journal: PLoS Medicine (2005)

The case report by Nautiyal et al. [1] is an instructive reminder that the fi rst episode of an acute painful Horner Syndrome should prompt imaging of the ipsilateral internal carotid artery, since carotid dissection (as well as other conditions, such as high-grade stenosis) needs to be ruled out.Unfortunately, the authors perpetuate the extremely common misconception that enophthalmos accompanies ptosis and miosis in human Horner Syndrome.It is only an illusion of enophthalmos caused by the ptosis.This is evident in the left eye of their patient in Figure 1 of the case report.Actual measurement with exophthalmometry clearly demonstrates the lack of enophthalmos.As stated by Loewenfeld ([2], p. 1139), "Animals such as cats, rats, or dogs have enophthalmos on the side of the sympathetic lesion.But in man, the enophthalmos is only apparent.The small palpebral fi ssure makes the eye look sunken in on the affected side, but the position of the globe in the orbit remains virtually unchanged.This has been found by all workers who have measured the supposed enophthalmos objectively."Loewenfeld cites four supportive references.Thompson and Miller ([3], p. 964) provide four additional references that the enophthalmos "is apparent rather than real.
Politics of conflict: doctors, like MPs, should declare their interests
Authors: D. Spence
Journal: BMJ (2010)

Professional politicians are a particular breed—pretending to listen, never actually answering a direct question, revelling in their opponents’ pain, and changing with their stance to match public opinion. They are fundamentally opportunistic, being the first to criticise others, especially in the public sector. So when pilloried in the parliamentary expenses scandal for employing their children and spouses; enriching themselves through property; and claiming for the petty to the preposterous, they found little sympathy from doctors. Now politicians are in the dock over lobbying—acting as paid mouthpieces …
Junior doctors object to "tax on training"
Authors: L. Beecham
Journal: BMJ (1997)

Junior hospital doctors are angry at the practice that some royal colleges have adopted in levying compulsory fees–in addition to examination fees–for taking part in and completing specialist training. They are also concerned about the Specialist Training Authority's (STA) decision to charge £250 ($400) for issuing the certificate of specialist training and to charge £1000 for an appeal.

The …
Studies on an Attenuated Measles-Virus Vaccine
Authors: Robert J. Haggerty, Roger J. Meyer, Ellenora Lenihan, Samuel L. Katz
Journal: New England Journal of Medicine (1960)

THE present study was designed to assess the effectiveness of measles vaccine (attenuated) among normal children living at home and exposed to the usual sibling or school measles contacts, to define the reactions encountered and the serologic response and to determine parent acceptance of this immunizing agent.MethodsFamilies enrolled in a special teaching program for medical students and house officers in training, the Family Health Care Program, were selected for the study when 2 or more children in a family gave no previous history of measles. This history was considered to be unusually accurate because most of these children . . .
Soft Tissue Injuries in Sports Medicine
Authors: W. N. Dodds
Journal: BMJ (1996)

Louis C Almekinders Blackwell Science £35 pp338 ISBN 0-86542-382-2

As the majority of sporting injuries are of soft tissue, it was intriguing to delve into this book during the recent Olympic Games. I was looking for faster, more effective treatment for the ever speedier sportsman and woman, some of whom seem increasingly injury prone. I did not find it. Nor was there mention of local anaesthetic for stress fractures or injections of homoeopathic remedies for other lower limb injuries. I am not sure if I was relieved or disappointed.

The first part covering basic principles fulfilled the editor's aim of educating …
Natural history and predictors of disease severity in chronic hepatitis C
Authors: Julien Massard, Vlad Ratziu, Dominique Thabut, Joseph Moussalli, Pascal Lebray, Yves Benhamou, Thierry Poynard
Journal: Journal of Hepatology (2005)

Cirrhosis is the end-stage consequence of fibrosis progression in patients with chronic hepatitis C. The median time from infection to cirrhosis is 30 years, with a high inter-individual variability, which is now better understood. Several factors have been clearly shown to be associated with fibrosis progression rate: duration of infection, age, male gender, alcohol consumption, HIV co-infection and low CD4 count. Metabolic conditions such as steatosis, being overweight and diabetes are emerging as independent co-factors of fibrogenesis. The recent validation of non-invasive biomarkers should facilitate the study of fibrosis progression in large populations.
THE TREATMENT OF COLDS IN TUBERCULOUS SUBJECTS
Authors: F. E. Gunter
Journal: BMJ (1924)

<h3>Objective</h3> This trial investigated whether advanced paramedics from a UK regional ambulance service have the ability to acquire and interpret diagnostic quality ultrasound images following a 2-day programme of education and training covering the fundamental aspects of lung ultrasound. <h3>Method</h3> The participants were tested using a two-part examination; assessing both their theoretical understanding of image interpretation and their practical ability to acquire diagnostic quality ultrasound images. The results obtained were subsequently compared with those obtained from expert physician sonographers. <h3>Results</h3> The advanced paramedics demonstrated an overall accuracy in identifying the presence or absence of pneumothorax in M-mode clips of 0.94 (CI 0.86 to 0.99), compared with the experts who achieved 0.93 (CI 0.67 to 1.0). In two-dimensional mode, the advanced paramedics demonstrated an overall accuracy of 0.78 (CI 0.72 to 0.83), compared with the experts who achieved 0.76 (CI 0.62 to 0.86). In total, the advanced paramedics demonstrated an overall accuracy at identifying the presence or absence of pneumothorax in prerecorded video clip images of 0.82 (CI 0.77 to 0.86), in comparison with the expert users of 0.80 (CI 0.68 to 0.88). All of the advanced paramedics passed the objective structured clinical examination and achieved a practical standard considered by the examiners to be equivalent to that which would be expected from candidates enrolled on the thoracic module of the College of Emergency Medicine level 2 ultrasound programme. <h3>Conclusion</h3> This trial demonstrated that ultrasound-naive practitioners can achieve an acceptable standard of competency in a simulated environment in a relatively short period of time.
Composition of human pulmonary surfactant varies with exercise and level of fitness.
Authors: I R Doyle, M E Jones, H A Barr, S Orgeig, A J Crockett, C F McDonald, T E Nicholas
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

We have tested the hypothesis that the composition of alveolar surfactant varies with pattern of breathing and level of fitness. We examined three major components of surfactant, surfactant protein A (SP-A), disaturated phospholipids (DSP), and cholesterol (CHOL) in bronchoalveolar lavage (BAL) fluid from 12 healthy men before and after exercise. Fitness was assessed as work load/heart rate ([kpm.min-1]/[HR.HRmax-1]) achieved during cycling for 30 min at 90% theoretical maximal heart rate. Using a bronchoscope, four 20-ml vols of 0.15 M NaCl at 37 degrees C were instilled and then recovered from first a right upper and then a right lower lobe segmental bronchus. As we found no differences in the BAL from upper and lower lobes, the fluid was combined. We found a direct relationship between CHOL and DSP (rs = 0.84, p < 0.001), SP-A and CHOL (rs = 0.40, p < 0.025), and between SP-A and DSP (rs = 0.44, p < 0.025). The change in the ratios CHOL/DSP, SP-A/CHOL, and SP-A/DSP immediately after exercise was correlated with fitness (rs = -0.56, p < 0.025; rs = 0.75, p < 0.005; rs = 0.62, p < 0.025, respectively). We conclude that the composition of surfactant can change rapidly with exercise in a manner related to fitness, and we suggest that this is consistent with the existence of at least two pools of tissue surfactant of different composition supplying the alveolar compartment.
Selecting medical students: Evidence based admissions procedures for medical students are being tested
Authors: David A Powis, Miles Bore, Donald Munro
Journal: BMJ (2006)

EDITOR—Parry et al's comprehensive summary of admissions processes in English medical schools closes with a gloomy picture of the current state of UK medical student selection.1

There is, in fact, much going on. For example, one medical school has run trials of a personal qualities assessment procedure (PQA) for selecting medical students. In addition, Lumsden et al, …
Urea Cycle Enzymes After Portacaval Shunting
Authors: Henry Brown
Journal: JAMA (1965)

Urea cycle enzymes which broadly control ammonia metabolism in the liver are being investigated after experimental portacaval shunt operations. The shunt operation has received considerable attention from clinicians because it is a definitive treatment for hemorrhage from esophageal varices secondary to portal hypertension. The role of urea cycle enzymes is of particular interest in this situation because of striking changes in ammonia and cerebral metabolism induced by this surgery. There is good evidence that under these conditions there is a close relationship between ammonia utilization and cerebral metabolism,1but the mechanism for this is not well understood. In this study attention is focused only on one phase, utilization of ammonia by the liver, as a part of a broader over-all study of liver-brain relationships.  Ammonia, commonly thought of in terms of toxicity in hepatic failure and coma, is in point of fact an essential metabolite in the hepatic urea
Are general practitioners prepared to share information about their patients and their work?
Authors: M. Pringle
Journal: BMJ (1988)

A questionnaire survey of the 44 general practices in Central Nottinghamshire Health District elicited 43 responses. Ten scenarios on sharing information were graded on a five point scale by each practice according to its willingness to share the information. Responses varied from 41 practices that would at least “probably” give the number of their young chronic sick patients to the local district health authority to 17 practices that were positive towards sharing with a local charity the names of elderly patients living alone. This second example raises profound issues of confidentiality. The extent to which practices were prepared theoretically to share practice generated information with outside bodies was generally high and showed a willingness to do so if the reasons were sound and the requesting body was acceptable.
Patricia Elizabeth Verdon
Authors: J. Verdon
Journal: BMJ (2003)

Microbiologist Portsmouth Group of Hospitals 1960-84 (b Madras 1921; q Royal Free Hospital, London, 1946), died from a stroke on 27 February 2003.






During the second world war Pat and other Royal Free students were evacuated to Exeter and almost immediately became victims of an air raid when the anatomy room received a direct hit. This caused some consternation among the air raid patrol wardens as some of the bodies laid out for dissection were hurled out into the street. After house jobs at the Royal Free, Pat married George Verdon, a naval officer, and spent the next 14 years of her life raising a family and doing part time general practitioner work until she joined the Portsmouth Hospitals group. Pat was a fine singer. She leaves George and three sons.
A Community Plan for Military Alcoholics
Authors: ROBERT W. CONROY, BERNARD FRIEDBERG, PATRICK KRIZAJ
Journal: American Journal of Psychiatry (1971)

The authors formulated a plan for treating alcoholic servicemen. After a brief period of detoxification, patients were encouraged to have contact with the Mental Hygiene Consultation Service on an outpatient basis; disulfiram and Alcoholics Anonymous were also employed. Paraprofessional personnel provided the manpower needed to operate the program successfully. Although obstacles such as community resistance to the program were encountered, the results were favorable.
Immunology, Immunopathology, and Immunity
Authors: Stanley Cohen
Journal: JAMA (1973)

It is now well recognized that the various mechanisms that comprise the immune response may be either beneficial or harmful to the individual, depending on the specific biologic circumstances. Thus, immunity and immunopathology represent two faces of the same coin. Of the numerous introductory texts available in the field, Dr. Sell's provides the best focus on this duality. He begins with a section devoted to the basic aspects of immunology, which is well written and organized along fairly standard lines. The next major section is devoted to immunopathologic disorders, beginning with prototypic reactions such as anaphylaxis, the Arthus reaction, and delayed hypersensitivity, and concluding with a discussion of specific immunopathologic states. In this part of the book there are a number of tables and diagrams that organize the rather complex subject matter in an extremely lucid manner. Good examples of such organization are the summaries of the interrelationships of various
Modulation of Endothelium-Dependent Hyperpolarization and Relaxation to Acetylcholine in Rat Mesenteric Artery by Cytochrome P450 Enzyme Activity
Authors: Guifa Chen, Donald W. Cheung
Journal: Circulation Research (1996)

Acetylcholine (ACh) induced hyperpolarization and relaxation in rat mesenteric arteries contracted with norepinephrine, as indicated from studies with simultaneous microelectrode and tension recordings. We tested whether the hyperpolarization to ACh was modified by induction and depletion of cytochrome P450 enzymes. Enzyme induction by treating the animals with 3-methylcholanthrene and β-naphthoflavone for 3 days resulted in a significant increase in the endothelium-dependent hyperpolarization to a maximum of 22.7±1.0 mV from 13.9±0.4 mV in arteries from untreated animals. Enzyme depletion by treating the animals with CoCl 2 for 2 days resulted in a significant reduction in the maximum hyperpolarization to 9.9±0.7 mV. When NO synthesis was inhibited by N ω -nitro- l -arginine, the relaxation was correlated to hyperpolarization. The N ω -nitro- l -arginine–resistant responses were significantly inhibited by clotrimazole. The relaxation to ACh was not altered by enzyme induction but was significantly reduced by enzyme depletion. In KCl-contracted arteries, modification of cytochrome P450 enzyme activity had no significant effect on the relaxation to ACh. Similarly, hyperpolarization and relaxation to pinacidil were not significantly affected. These results suggest that the hyperpolarization response to ACh is closely regulated by cytochrome P450–dependent enzymes.
Factors Associated With Fatalities and Injuries From Hot-Air Balloon Crashes
Authors: Clayton T. Cowl, Michael P. Jones, Charles F. Lynch, Nancy L. Sprince, Craig Zwerling, Lawrence J. Fuortes
Journal: JAMA (1998)

Context.—Despite the increased popularity of hot-air balloon flight, data on injuries and fatalities associated with hot-air balloon crashes are limited.Objective.—To determine factors associated with injury and death in hot-air balloon crashes.Design.—Retrospective review of data collected from reports and investigations by the Civil Aeronautics Board and the National Transportation Safety Board.Study Subjects.—Individuals involved in US hot-air balloon crashes from 1964 to 1995.Main Outcome Measures.—Total number of crashes and factors associated with fatality or serious injury.Results.—From 1964 to 1995, a total of 495 hot-air balloon crashes involving 1533 persons were reported and included 92 fatalities and 384 serious injuries. Pilot error or incapacitation was determined subjectively by crash investigators to contribute to 85.1% of the crashes. In univariate analysis, collision with the ground was the most significant predictor of a fatality or serious injury (P<.001), and power-line contact was the most significant predictor of fatality (P<.001). In multiple logistic regression, only the type of object struck by a balloon predicted a fatal crash or a fatality or serious injury.Conclusions.—Although a number of factors likely contribute to increased severity of hot-air balloon crashes, the object struck during a crash is most predictive of fatality or serious injury. Preventive efforts are needed to decrease future injuries.