tbuckley/cabot-search huggingface dataset:
Inflation in epidemiology: "The proof and measurement of association between two things" revisited
Authors: G. D. Smith, A. N Phillips
Journal: BMJ (1996)

To assess the response to vaccination, quantity (concentration) and quality (avidity) of neutralizing antibodies are the most important parameters. Specifically, an increase in avidity indicates germinal center formation, which is required for establishing long-term protection. For influenza, the classical hemagglutination inhibition (HI) assay, however, quantifies a combination of both and to separately determine avidity requires high experimental effort. Here, we present a biophysical model that infers neutralizing IgG avidities from HI titers and IgG concentrations. We applied our model to infer IgG avidities against the pandemic 2009 H1N1 influenza virus in vaccinated hematopoietic stem cell transplantation patients (n = 45) and validated our results with independent avidity measurements. The model predicted that increased IgG concentrations mainly contribute to observed HI titer increases and that immunosuppressive treatment is associated with lower baseline avidities. Because the model requires only easy-to-establish measurements as inputs, we anticipate that it will help to disentangle causes for poor vaccination outcomes also in larger vaccine studies.
"Human tragedy" was due to delay in achieving national self sufficiency in blood products
Authors: C. Dyer
Journal: BMJ (2009)

An independent inquiry has condemned government procrastination that led to a “horrific human tragedy” in which thousands of people in England and Wales with haemophilia became infected with HIV and hepatitis C from contaminated blood products.

The inquiry, led by the Labour peer and former solicitor general Peter Archer, endorsed the description of the saga by Robert Winston, a doctor and member of the House of Lords, as “the worst treatment disaster in the history of the NHS.”

Some 4670 people treated with blood products in the 1970s and 1980s were infected with hepatitis C, of whom 1243 were also infected with HIV.

Nearly 2000 haemophiliac people have died as a result. For several years after fears were raised about the risk of infection, the NHS continued to buy …
Isabel Mary Cant (nee Martineau)
Authors: J. R Mann, R. H R White
Journal: BMJ (2008)

A daughter of the late Charles Martineau, formerly professor of accounting at Birmingham University, Isabel Mary Cant (nee Martineau) she became vice president of the students’ union at university. She met her future husband, William Cant ( BMJ obituary 1981;283:798), while both were working at the General Hospital. They married in 1939, …
The consultant's job
Authors: K. B. Chambers, M. S. Everest, D. C. Gardner, J. N. Gibson, W. M. R. Henderson, J. G. Hill, N. M. Jacoby, R. C. King, W. L. Lawes, G. A. D. Lavy, T. S. Leedham, M. B. McEvedy, J. H. Mayer, R. M. Miller, B. G. Pickles, C. W. J. Ussher
Journal: BMJ (1969)
How long does it take to become fit?
Authors: J. W Todd
Journal: BMJ (1981)

sprinters lack stamina, but I imagine that no one would question their cardiopulmonary fitness-while in training.I am also worried by the modified physical fitness index, as this fails to take account of the resting pulse rate.Surely a formula based on percentage increase over resting rate at two, five, and 10 minutes would seem more reasonable, since the normal resting pulse rate can vary from the 40s to the 90s at least-or does a naturally slow pulse rate confer a fitness advantage ?Interestingly, Lieutenant-ColonelPearn referred to Zatopek's fitness index of 172; he was a distance runner with a resting pulse rate of about 40 per minute.But I wonder how Zatopek would have fared on the squash court, where explosive bursts of energy are required, or in gymnastics, in which a completely different sort of fitness and body control is demanded, or in the swimming pool.He certainly would have been
Hepatic Abnormalities in Congestive Heart Failure
Authors: THOMAS J. WHITE, ROBERT B. WALLACE, ANGELO M. GNASSI, NORVAL F. KEMP, H. PRESTON PRICE, CARROLL M. LEEVY
Journal: Circulation (1951)

Needle biopsies of the liver were performed on 30 patients with heart failure and correlated with clinical features and biochemical liver function studies. Hepatic biopsy served as a useful adjunct to other methods in deciding the status of the liver in this group. Type of heart disease, degree of heart failure and length of heart failure could not be correlated with the observed histology. Neither history, physical examination, nor biochemical functional studies provided sufficient information to predict anatomy with certainty. A histologic diagnosis improved both therapeutic and prognostic perspective.
"Quick fixes" are not answer to financial failure in NHS, says think tank
Authors: Z. Kmietowicz
Journal: BMJ (2014)

Supporting hospitals in England that are facing financial failure requires a measured approach that takes account of the local health economy rather than “quick fixes,” a new report has said.1

The report from the health policy think tank the King’s Fund has warned that the prolonged fall in funding meant that the NHS was now facing a period when even the best managed organisations would struggle to avoid financial failure. In 2013-14 just over a quarter of NHS trusts ended in deficit, with a net deficit of £241m (€300m; $390m), and foundation trusts had a gross deficit of £307m, with 27% of these trusts in the red. 

Reports from …
Inquiry ordered into transfer of the frail elderly
Authors: J. Warden
Journal: BMJ (1998)

The transfer of frail elderly patients between hospitals and care homes in England may be stopped or severely restricted if the results of an investigation ordered by the health secretary, Frank Dobson, support his impression that too many old people die as a result of being moved.

Mr Dobson told the Commons select committee on administration, which monitors the work of the health …
Reduction in Mortality in Subjects With Homozygous Familial Hypercholesterolemia Associated With Advances in Lipid-Lowering Therapy
Authors: Frederick J. Raal, Gillian J. Pilcher, Vanessa R. Panz, Hendrick E. van Deventer, Brigitte C. Brice, Dirk J. Blom, A. David Marais
Journal: Circulation (2011)

Background— Homozygous familial hypercholesterolemia is an inherited disorder caused by mutations in both low-density lipoprotein receptor alleles, which results in extremely elevated plasma low-density lipoprotein cholesterol concentrations and very early morbidity and mortality due to cardiovascular disease. Methods and Results— To evaluate the impact of advances in lipid-lowering (predominantly statin) therapy on cardiovascular disease morbidity and mortality in a large cohort of patients with homozygous familial hypercholesterolemia, the records of 149 patients (81 females, 68 males) from 2 specialized lipid clinics in South Africa were evaluated retrospectively. Homozygous familial hypercholesterolemia was diagnosed by confirmation of mutations in genes affecting low-density lipoprotein cholesterol or by clinical criteria. A Cox proportional hazard model with time-varying exposure was used to estimate the risk of death and major adverse cardiovascular events among statin-treated patients compared with statin-naive patients. The hazard ratio for benefit from lipid therapy, calculated with the Cox proportional hazards model for the end point of death, was 0.34 (95% confidence interval 0.14–0.86; P =0.02), and for the end point of major adverse cardiovascular events, it was 0.49 (95% confidence interval 0.22–1.07; P =0.07). This occurred despite a mean reduction in low-density lipoprotein cholesterol of only 26.4% (from 15.9±3.9 to 11.7±3.4 mmol/L; P &lt;0.0001) with lipid-lowering therapy. Conclusions— Lipid-lowering therapy is associated with delayed cardiovascular events and prolonged survival in patients with homozygous familial hypercholesterolemia.
A 1-year study of salmeterol powder on pulmonary function and hyperresponsiveness to methacholine☆☆☆★★★
Authors: James P. Kemp, Arthur C. DeGraff Jr, David S. Pearlman, Yonghua Wang, Teresa E. Arledge, Mary Beth Welch, Thomas G. O’Riordan, Myra Rosario Herrle, Edmundo G. Stahl
Journal: Journal of Allergy and Clinical Immunology (1999)
Science, Politics, and the Pharmaceutical Industry: Controversy and Bias in Drug Regulation
Authors: J. Collier
Journal: BMJ (1995)

John Abraham UCL Press, pounds sterling12.95, pp 308 ISBN 1 85728 200 0

John Abraham's book on the relationship between the regulators and the pharmaceutical industry is a classic. For years there have been suspicions, and even allegations, that all too often those responsible for regulating the licensing and marketing of drugs have favoured the interests of manufacturers rather than those of the consumer. Hard data were often sparse—in the United Kingdom not least because of the excessive secrecy surrounding licensing.

Sometimes the special relationship was obvious; what other explanation could there be for the way the Department of Health (now the Medicines Control …
DERMATITIS DUE TO TRIETHYLENE MELAMINE THERAPY
Authors: Abraham M. Frumin
Journal: JAMA (1953)

The administration of triethylene melamine (TEM) in various hematological disorders has led to the widespread use of this drug since it was introduced in 1951.<sup>1</sup>The usual side-effects have been manifested by a toxic depression of the marrow, i. e., anemia, thrombocytopenia, leukopenia, and gastrointestinal disturbances, with nausea and vomiting. We wish to present what appears to be the first recorded instance of a dermatitis due to such therapy. <h3>REPORT OF A CASE</h3> A 57-year-old white woman was admitted to the Albert Einstein Medical Center, Southern Division, Medical Service No. 1, because of weakness of six months' duration associated with a 50 lb. (22.7 kg.) weight loss. Dyspnea on exertion was recently noted. Fever and night sweats were not present. Physical examination revealed blood pressure to be 132/80 mm. Hg, pulse 82, respirations 18, and temperature 98.6 F. There was no pallor, icterus, splenomegaly, purpura, or glossitis. Generalized adenopathy
Dual functions of cell-autonomous and non–cell-autonomous ADAM10 activity in granulopoiesis
Authors: Masaki Yoda, Tokuhiro Kimura, Takahide Tohmonda, Shinichi Uchikawa, Takeshi Koba, Jiro Takito, Hideo Morioka, Morio Matsumoto, Daniel C. Link, Kazuhiro Chiba, Yasunori Okada, Yoshiaki Toyama, Keisuke Horiuchi
Journal: Blood (2011)
Seizures and the Dandy-Walker Syndrome: A Case of Suspected Pseudoseizures
Authors: Iulian Iancu, Moshe Kotler, Neil Lauffer, Pinhas Dannon, Elie Lepkifker
Journal: Psychotherapy and Psychosomatics (1996)

Background: A major pitfall in the diagnosis of conversion disorder is the difficulty in ruling out organic causes. Methods: A 19-year-old female was referred with seizures and the Dandy-Walker syndrome. We continued the medical workup and also treated the patient with psychotherapy. Results: The patient's symptoms gradually abated, however, the headaches remained. No neurologic illness evolved during the follow-up. Conclusions: The diagnosis of pseudoseizures is suggested according to clinical evaluation and follow-up. A multidisciplinary approach is recommended in such cases for efficient diagnosis and treatment.
Cullen's and Turner's Signs
Authors: Farouk Mookadam, Maja Cikes
Journal: New England Journal of Medicine (2005)

A 72-year-old man with unstable angina was admitted to the hospital. On the sixth day of heparin therapy, the hemoglobin level decreased from 11.7 to 9.4 g per deciliter. On physical examination, the vital signs were stable, and there was a grade 3/6 systolic murmur consistent with aortic stenosis. Ecchymoses in the periumbilical region (Cullen's sign) (Panel A) and flank (Turner's sign) (Panel B) were noted. Computed tomographic scanning confirmed a retroperitoneal hemorrhage. In 1918, Cullen was the first to describe an umbilical discoloration in a patient with a ruptured extrauterine pregnancy. In 1919, Turner described a “dirty green” discoloration . . .
Immune response to stage-specific surface antigens of the parasitic nematode Trichinella spiralis.
Authors: M Philipp, P M Taylor, R M Parkhouse, B M Ogilvie
Journal: The Journal of Experimental Medicine (1981)

Rats were infected with the nematode Trichinella spiralis and the primary serum antibody response to antigenic surface proteins of infective larvae, intestinal worms, and newborn larvae was studies. 1 wk after infection, the sera contained antibodies to surface antigens of both infective larvae and intestinal worms. These early sera, however, failed to react with newborn larvae surface antigens. In addition, adsorption of sera with living intestinal worms or infective larvae removed antibodies to surface antigens of the homologous stage only. Finally, the time-course of appearance of antibodies that mediate eosinophil adherence to the surface of each stage of the parasite. We concluded that in a primary infection in rats, the surface proteins of T. spiralis used in this study are antigenically stage specific. Furthermore, they could be targets for the stage-specific, antibody-dependent eosinophil-mediated destruction of this parasite, known to occur in vitro.
Intravesical Foreign Body
Authors: Nicola Mondaini, Riccardo Bartoletti
Journal: New England Journal of Medicine (2007)

An 82-year-old woman presented with abdominal colic. She had a 20-year history of type 2 diabetes and a 2-year history of recurrent urinary tract infections despite many courses of antimicrobial therapy. She lived in a long-term care facility. An abdominal radiograph showed a large stone in her bladder, with a foreign body in the center of the stone (Panel A). On cystotomy (Panel B), an infected bladder stone measuring 6 by 2 by 0.5 cm was removed (Panel C), and a pen cap was found at the center (Panel D). The patient was discharged 2 days later and had a . . .
A treatable cause of shortness of breath
Authors: S. Nikolaou, D. P. Jenkins
Journal: BMJ (2013)

An 81 year old man was referred to a respiratory doctor with a two year history of worsening shortness of breath on exertion. He also described presyncopal symptoms caused by exertion and one episode of collapse after walking up a hill.

His medical history included benign prostatic hypertrophy and encephalitis. He was a non-smoker, drank little alcohol, and had previously led an active life.

On examination he was afebrile, his blood pressure was 134/84 mm Hg, his heart rate was 80 beats/min in sinus rhythm, and his oxygen saturation on room air was 95%. His jugular venous pressure was not raised. He had a loud P2 component of the second heart sound and no ankle oedema. His lung fields were clear. Electrocardiography showed ST depression and T wave inversion anterolaterally. Chest radiography showed enlarged hila.

An echocardiogram showed normal left ventricular function with a dilated right ventricle and pulmonary artery systolic pressure of 63-68 mm Hg. Computed tomography pulmonary angiography showed a dilated right ventricle, dilation of the pulmonary trunk, multiple webs in pulmonary artery branches, and thrombus layering along the right main pulmonary and right upper lobe pulmonary artery. He was referred to a regional specialist centre to confirm the diagnosis and decide further management.



### 1 What is the diagnosis?

#### Short answer

This patient has chronic thromboembolic pulmonary hypertension (CTEPH).

#### Long answer

Echocardiography is often the first investigation to suggest pulmonary hypertension. It may show dilation of the right ventricle, raised right ventricular systolic pressure, and tricuspid regurgitation. In our patient, computed tomography pulmonary angiography showed a dilated right ventricle, dilation of the pulmonary trunk, multiple webs in pulmonary artery branches, and thrombus layering along the right main …
A History of Education in Public Health: Health That Mocks the Doctor's Rules
Authors: Arnold S. Monto
Journal: JAMA (1992)

While the United States and Britain have many features in common, their approaches to the organization of medical services have been historically distinct. Major differences have also existed in public health education and practice, and these differences are carefully documented in<i>A History of Education in Public Health</i>, edited by Elizabeth Fee and Roy M. Acheson, describing the history of public health education in both countries. The origins of public health were similar on both sides of the Atlantic. Dramatic social changes following the industrial revolution left large segments of the population, urban and rural, in poverty at a time when the causes of infectious and other diseases began to be identified. In Britain, public health emerged as a medical specialty, and recipients of the Diploma in Public Health (DPH) worked at least parttime for a governmental health authority, often to supplement income generated by fee-for-service practices. Only one institution
An immunomodulatory role for CD4+CD25+ regulatory T lymphocytes in hepatitis C virus infection
Authors: Roniel Cabrera, Zhengkun Tu, Yiling Xu, Roberto J. Firpi, Hugo R. Rosen, Chen Liu, David R. Nelson
Journal: Hepatology (2004)

The CD4(+)CD25(+) regulatory T lymphocytes have been implicated in suppressing T cell immune responses. Our aim was to characterize the frequency, phenotype, function, and specificity of CD4(+)CD25(+) T cells in hepatitis C virus (HCV) infection. Peripheral CD4(+)CD25(+) cells from recovered (n = 15), chronic infected (n = 30), and normal control (n = 15) subjects were analyzed ex vivo for quantitation, phenotype, and effect on HCV-specific interferon gamma production and proliferation. CD4(+)CD25(+) specificity was determined by intracellular cytokine staining for interleukin 10 (IL-10). A higher proportion of CD4(+)CD25(+) were found in chronic infection (mean, 3.02%) when compared with recovered (1.64%, P = .001) and normal controls (2.27%, P = .02). CD4(+)CD25(+) cells display CD45RO(high), CD45RA(low), CD28(high), CD62L(high), and CD95(high) phenotype. HCV-specific interferon gamma activity was enhanced in peripheral blood mononuclear cells depleted of CD4(+)CD25(+) and suppressed in peripheral blood mononuclear cells enriched with CD4(+)CD25(+). Depletion of CD4(+)CD25(+) cells also enhanced HCV-specific CD4(+) and CD8(+) T cell proliferation. Cytokine analysis suggested CD4(+)CD25(+) cells secrete transforming growth factor beta (TGF-beta(1)) and IL-10. The inhibitory role for TGF-beta(1) was confirmed by anti-TGF-beta(1). Transwell studies showed CD4(+)CD25(+) mediated suppression to be dose dependent and requiring cell contact. CD4(+)CD25(+) cells showed HCV-specificity through IL-10 production, with a frequency ranging from 1.9% to 5.3%. A positive correlation was detected between CD4(+)CD25(+) T cell frequency and HCV RNA titer, whereas an inverse relation was found with liver inflammatory activity. In conclusion, CD4(+)CD25(+) T lymphocytes constitute a highly differentiated population and appear to play a role in viral persistence by suppressing HCV-specific T cell responses in a cell-cell contact manner.
F-18 FDG PET-CT Imaging in Gastric Sarcoma
Authors: Brian Gamble, Murali Meka, Linh Ho
Journal: Clinical Nuclear Medicine (2009)

We report the F-18 fluorodeozyglucose positron emission tomography computed tomography appearance of a biopsy-proven primary gastric sarcoma in a 24-year-old man who presented with early satiety, dyspepsia, and weight loss. Gastric sarcoma is a rare form of malignancy constituting approximately 0.3% to 8% of malignant soft tissue tumors of the stomach. The tumor appears as an ill-defined heterogeneous mass protruding off the lesser curvature of the stomach on computed tomography with central photopenia and peripheral intense uptake on positron emission tomography images.
Pharmacophore modeling and virtual screening for the discovery of new fatty acid amide hydrolase inhibitors
Authors: Dong-sheng Zhao, Hai-yan Wang, Zhi-hui Lian, Da-xiong Han, Xin Jin
Journal: Acta Pharmaceutica Sinica B (2011)

A predictive pharmacophore model has been generated from a series of diverse fatty acid amide hydrolase (FAAH) inhibitors and the optimal pharmacophore model applied in virtual screening. The pharmacophore model was based on a training set of 21 compounds carefully selected from the published literatures. The optimal model Hypo-1 included four features (two hydrogen-bond acceptor units, one aromatic hydrophobic unit and one aromatic ring unit) and two excluded volumes. Cross-validation of the model confirmed that Hypo-1 was not generated by chance correlation. A large test set of 55 compounds showed that Hypo-1 performed well in classifying highly active and less active FAAH inhibitors. Superimposition analysis of the FAAH X-ray crystal structure and the pharmacophore Hypo-1 further validated the adequacy of the model. Virtual screening generated a total of 976 hits from the Zinc Natural Products database, a hit rate of 1.04% and enrichment of 83.89. The acceptable hit rate further supports the use of Hypo-1 as a 3D query tool for virtual screening.
Reply to Thoufeeq
Authors: P. van Putten, F. ter Borg, R. Adang, J. Koornstra, M. Romberg-Camps, R. Timmer, A. Poen, M. van Leerdam, E. Kuipers
Journal: Endoscopy (2013)

Dr Thoufeeq raises some important issues with respect to our paper on nurse endoscopists performing colonoscopy [1]. As it is gastroenterologists who train and supervise nurse endoscopists, it is indeed important that they support nurse endoscopy practice. Gastroenterologists are, in general, positive toward the important, albeit restricted role of nurse endoscopists [2] [3]. Potential benefits are recognized but concerns are expressed, including the need for adequate training and quality assurance, as well as patient experience and the potential interference in training of gastroenterology fellows. Dealing with these concerns is a prerequisite for institutions considering the introduction of nurse endoscopists.
Prospects for Research in Hematologic Disorders
Authors: William C. Mentzer, Yuet Wai Kan
Journal: JAMA (2001)

Sickle cell anemia and thalassemia constitute the most common genetic diseases in the world. Affected patients carry a heavy burden of morbidity and early mortality. With improved understanding of the pathophysiology and molecular basis of these diseases, treatment is evolving from management of symptoms to more effective strategies that aim to modify diseased red blood cells or replace them with normal cells. Available treatment options include red blood cell transfusions, pharmacologic interventions to increase fetal hemoglobin levels, and stem cell transplantation. Improvements in these approaches or the development of means to replace defective genes with normal ones using techniques of gene transfer offer hope for the future.
Prevalence of the Metabolic Syndrome in Middle-Aged Men and Women
Authors: Raquel Villegas, Ivan J. Perry, Don Creagh, Rita Hinchion, Domhnall O’Halloran
Journal: Diabetes Care (2003)

Whereas the global epidemic of type 2 diabetes is now well characterized (1), data on the occurrence of the metabolic syndrome in populations are limited (2–5). The lack of an accepted internationally agreed definition has impeded epidemiological work on the prevalence and antecedents of this syndrome. Two definitions of the syndrome have been proposed, one by the World Health Organization (MSWHO) (6), and one in the U.S. Third Report of …