tbuckley/cabot-search huggingface dataset:
SADE Database for Endoscopic Procedures: Aspects of Clinical Use
Authors: L. Aabakken, J. Westerheim, B. Hofstad, S. Larsen, M. Osnes
Journal: Endoscopy (1991)

The time aspects of daily use of a clinical database system in an endoscopy department were studied. The SADE database system for endoscopic procedures was introduced for daily use at Ullevål Hospital on 1 January 1989. The average weekly programme of the endoscopy unit includes 57 gastroduodenoscopies, 23 colonoscopies and 12 ERCP/EPTs. During three consecutive weeks of the study the mean physician input time was 4 min 17 sec per patient (range 57 sec to 15 min), individual variation depending mainly on the extent of the report. Assistants spent a mean time of 4 min 23 sec for each patient. Thus, a total of 8 min 40 sec was spent for every patient seen. Endoscopic units should analyze their routines and needs before introducing an electronic data base manager.
Increased expression of a brain/embryo-type myosin heavy chain isoform (MIIB2) in mesangial proliferative glomerulonephritis
Authors: Masanori Kishino, Akihiko Kimura, Kazuya Yamaguchi, Haruhisa Ohtani, Yoichi Yamada, Toshio Takahashi, Masatoshi Mune, Keiji Mimura, Takao Maeda, Sueo Matsumura, Tsutomu Tsuji, Susumu Yukawa
Journal: Kidney International (1996)
NHS has still not learnt the lessons of Bristol
Authors: Clare Dyer
Journal: BMJ (2006)

Five years after the report from the inquiry into the Bristol children’s heart surgery scandal, reforms have still failed to secure a safe health service, the former chairman of the inquiry warned last week.

In a lecture in central London Ian Kennedy said that safety would be the number one consideration in any patient centred service, yet government reforms had not given it a high enough priority.

Professor Kennedy called for a “cultural change” in the NHS to make it “patient centred,” rather than “patient led” (the government’s catchphrase), with professionals informing the public and helping patients make local choices about provision of services.

The Bristol inquiry was set up after a number of babies died or were brain damaged after heart surgery in the early 1990s. The report blamed not only poor surgery but a catalogue of systems failures, and it made a raft of safety recommendations that had implications throughout the NHS.

A surgeon and the medical director were struck off the medical register after the affair, and another surgeon was banned from operating on children for three years.

After the Bristol inquiry report the government launched a number of initiatives to improve safety, including setting up the Healthcare Commission, the regulatory body that Professor Kennedy now chairs.

It also established the National Patient Safety Agency to collect information on mistakes made by staff. Yet the National Audit Office recently reported that nearly one million incidents and near misses were flagged up in one year, of which 30% were avoidable.

Professor Kennedy said the picture was one of “pockets of activity, but poor overall coordination and limited analysis and dissemination of any lessons.”

He said, “Every month that goes by in which bad, unsafe practice is not identified and rooted out and good practice shared is a month in which more patients die or are harmed unnecessarily.”

He highlighted an initiative instigated in the United States by the Institute for Health Improvement to prevent 100 000 unnecessary deaths in hospitals over a period of 18 months and then in every year thereafter (BMJ 2006;332:1468, 24 Jun). Last month the institute’s president, Don Berwick, announced that the campaign “had succeeded in avoiding the taking of 122 300 lives.”

Dr Berwick pinpointed six changes in practice, including using evidence based care to prevent deaths from heart attacks, preventing infections while patients were being treated through central lines or ventilators, and preventing errors in drug treatment.

The programme was entirely voluntary, he added, and this illustrated the fact that “change comes about not by being imposed from above but by being facilitated and then owned and supported by those who have to change.”

More than 50 US healthcare organisations serve as “nodes” for the campaign, leading initiatives on a state and local level, coordinating technical assistance, and providing peer to peer opportunities for learning.
Diversity in the practice of district ethics committees.
Authors: C. Gilbert, K. W. Fulford, C. Parker
Journal: BMJ (1989)

A survey of ethics committees in district health authorities was carried out to find out the size and make up of committees and what information and guidance they offered to scientists who apply to do research. A sample (n = 28) of committees in England (n = 190), half from teaching districts and half from non-teaching districts, was contacted by post requesting this information. A high degree of diversity was found, not only in the methods that committees used but also in the ethical criteria each considered to be pertinent for research. It was also shown that published guidelines have made little impact. It is suggested that issuing more guidelines will be of limited use. Rather, the following are needed: information about why guidelines have been widely ignored, better communication between committees, some form of education for committee members, and a formal register of committees compiled.
Is Menarche Associated With Diabetic Retinopathy?
Authors: Barbara EK Klein, Scot E Moss, Ronald Klein
Journal: Diabetes Care (1990)

The goal of this study was to evaluate the association between menarchalstatus and diabetic retinopathy. Diabetic retinopathy was present in 51 of 129 females; 7 were premenarchal, and 44 were postmenarchal. The range of severity of retinopathy was greater in the postmenarchal group. In multivariateanalyses, duration of diabetes, menarchal status, and diastolic blood pressure were associated with the prevalence of diabetic retinopathy. After partitioning the duration of diabetes into years before and years after menarche, both were significant, but the number of years of diabetes after menarche was more strongly associated. At a 4-yr follow-up examination, more postmenarchal than premenarchal females had progression of their retinopathy (P = 0.06). These data suggest that stage of sexual development, as reflected by menarchal status, is associated with the presence and possibly the risk of progression of diabetic retinopathy.
LOCAL IMMUNIZATION OF RABBITS TO CUTANEOUS INFECTION WITH STAPHYLOCOCCUS AUREUS
Authors: Tracy B. Mallory, Alexander Marble
Journal: The Journal of Experimental Medicine (1925)

1. Bacterial filtrates were prepared by the methods described by Besredka, but these never developed any specific growth-inhibiting factors. 2. Such filtrates produced a strictly local immunity of the areas of the skin infiltrated but such protection was never greater than that produced with the broth from which they were prepared. This immunity was manifest within 8 hours and persisted at least 15 days. 3. Transcutaneous treatment by moist dressings soaked in either filtrate or broth were entirely ineffective. 4. Sites of healed cutaneous lesions show a strictly local and nonspecific immunity for a period of 5 to 6 weeks. 5. Repeated intracutaneous infection with virulent staphylococci failed to produce a general cutaneous immunity.
THE AETIOLOGY OF IMPETIGO CONTAGIOSA
Authors: M. ZAWAHRY, A. ABDEL AZIZ, M. SOLIMAN
Journal: British Journal of Dermatology (1972)

The study egtailed bacteriological investigation of 131 cases of impetigo contagiosa, including the isolation and identification of the offending organisms. The data showed the presence of Staphylococcus aureus in pure culture in 40.5% of the cases, and in mixed growth with betahaemolytic streptococci and other organisms in 47% of the cases. Streptococci came next in frequency and were isolated in pure culture from 9.1% of cases, and in combination with other organisms in 36.7% of the cases. A haemolytic diphtheroid having the characteristics of Corynebacterium pyogenes was isolated in pure culture from one case and in mixed growth in 5.3% of the cases.
Reform of the Veterans Affairs Health Care System
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1996)

The Department of Veterans Affairs has embarked on the reformation of its often-criticized health care system, an insular system that Congress has protected from the tumultuous forces that are reshaping other parts of American medicine. The department is decentralizing, reducing its inpatient capacity, reallocating resources to ambulatory care, and simplifying the convoluted method Congress designed to determine which veterans are eligible to receive medical services. These changes, which are shaking the rigid foundations of the Veterans Affairs system, are the subject of this report. They represent, in many respects, an attempt to transform the department's vast medical system along the . . .
CD4<sup>+</sup> T Cell and Natural Killer Cell-dependent Killing of <i>Mycobacterium tuberculosis</i> by Human Monocytes
Authors: TAKAHIRO YONEDA, JERROLD J. ELLNER
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

We established an in vitro model of the phagocytosis of Mycobacterium tuberculosis by human peripheral blood monocytes to evaluate the subsequent inhibition of intracellular replication of the organism. Highly purified T cells (94% CD3+/CD16−) or natural killer (NK) cells (96% CD16+/CD3−) isolated by Percoll discontinuous density gradient of peripheral blood mononuclear cells were incubated with M. tuberculosis-infected monocyte monolayers. Monocytes were lysed immediately and at 4, 7, and 10 d after infection for quantification of intracellular replication, which was assessed by quantitative plating techniques as colony-forming units (CFU). Whereas control monocytes permitted intracellular replication, T cells activated monocytes to kill 77% (p < 0.01) of intracellular M. tuberculosis compared with control monocytes by 10 d after infection. NK cells activated monocytes to kill 84% (p < 0.01) of M. tuberculosis in comparison with control monocytes. Lymphokine (IL-2)-activated-killer (LAK) cells were capable of activating monocytes to kill 97% (p < 0.01) of the intracellular organisms compared with control monocytes. In purified protein derivative (PPD)-positive donors, PPD-specific-CD4+ lymphocytes stimulated monocytes to kill intracellular M. tuberculosis in a Class II major histocompatibility complex-restricted manner. In contrast, in PPD-negative donors, CD4− lymphocytes activated monocytes in a genetically unrestricted manner. Both T cell supernatant and NK cell supernatant generated from cocultivation with M. tuberculosis-infected monocytes also activated monocytes to augment mycobactericidal function. In conclusion, T cells, NK cells, LAK cells, and their supernatants activated mycobactericidal function of monocytes, although these pathways of activation differed in terms of antigenic specificity and genetic restriction.
Sexual dimorphism of brain aromatase activity in medaka: induction of a female phenotype by estradiol.
Authors: A C Melo, J S Ramsdell
Journal: Environmental Health Perspectives (2001)

In this study we identified sex-dependent dimorphism of brain aromatase in the teleost medaka and examined its regulation by sex steriods. We first investigated differential distribution of brain aromatase activity in sexually mature male and female medaka in serial coronal sections of the brain and identified the hypothalamic nuclei contained in each section using the brain atlas of medaka. In the brain of male medaka, high levels of activity are localized in sections containing the preoptic (POA) and suprachiasmatic nuclei (SC) (63-75 fmol/hr) and low levels in the nuclei periventricular dorsalis (HD), ventralis (HV), and caudalis (Hc), nuclei diffusus of lobulus inferiores (NDIL), and nuclei tuberi anteriores (TA) and posteriores (TP) (< 25 fmol/hr). In the brain of female medaka high aromatase activity is localized in sections containing the HD, HV, Hc, NDIL, TA, and TP (85-80 fmol/hr) and highly variable levels in the POA and SC (23-70 fmol/hr). The concentration and time dependency of the exposure of male medaka to estradiol on the total brain aromatase activity and morphologic sex characteristics were determined next. Estradiol increased the activity of brain aromatase in a concentration-dependent manner at 2.5 and 25 microg/L, but the increase was lower at higher concentrations of the hormone. The effect was time dependent, gradually increasing up to the fifth day of exposure, after which it reached a plateau. Estradiol induction of brain aromatase analyzed using Lineweaver-Burke plots of saturation assays revealed a non-first-order reaction. The results indicate that a positive feedback mechanism regulates brain aromatase and imply that the sexual dimorphic distribution of aromatase may be highly sensitive to physiologic cues and environmental perturbations in fish.
Advancement of Men and Women in Medical Academia-Reply
Authors: Lila A. Wallis
Journal: JAMA (1982)

<h3>In Reply.—</h3> Placing each faculty member into one of the eight categories would require information unavailable in the medical school catalogues; such a study would require, therefore, total cooperation of the deans of all US medical schools. I do hope that such cooperation will be forthcoming, without the resistance that accompanied our last efforts. The statistical significance, however, of the study Dr Ruane proposes today will be questionable because of the small number of women in the full professorial rank. Secondly, the interpretation of the data from the various categories will be difficult without establishing other variables, for instance, if the woman physician's husband is supportive; ie, a "wife" or just another responsibility and a drain on her resources. Thirdly, how are you going to find out about and classify homosexual physicians' mates of either gender? This information may not be available from the most detailed curricula vitae. In one
Quinine for the Relief of Paresthesia of Undetermined Origin
Authors: Allen S. Johnson
Journal: New England Journal of Medicine (1952)

THE traditional pharmacologic importance of quinine has been due to its effect on malaria parasites and to its reputation as a stimulant of uterine contractions. More recently, it has been found of value as a muscle relaxant in various types of myotonia. The curare-like action of quinine in this condition has led to its wide use in an analogous clinical entity characterized by night cramps, usually in the calves of the legs. This syndrome, when not the result of frank arterial insufficiency, usually responds promptly to 0.3 gm. (5 gr.) of quinine sulfate given prophylactically at bedtime or to the . . .
Letter: Dangers of oxytocin-induced labour to fetuses.
Authors: M Thiery
Journal: BMJ (1974)

residual radioactivity in serum after incubation with resin is assessed and therefore a free thyroxine index is calculated as de- scribed by Dr. D'Haene and his colleagues by dividing P.B.I. by T-3 B.C. index.We hope this comment clarifies the situation and reinforces the need for a clear understanding of the method used to assess the T-3 resin uptake.-Weare, etc.,
Comparison of Warfarin and External Pneumatic Compression in Prevention of Venous Thrombosis After Total Hip Replacement
Authors: Charles W. Francis
Journal: JAMA (1992)

<h3>Objective.</h3> —To compare the effectiveness and safety of warfarin and external pneumatic compression (EPC) in prevention of venous thrombosis after total hip replacement. <h3>Design.</h3> —Prospective, randomized trial in consecutive patients, with blinded assessment of the primary end point. <h3>Setting.</h3> —University medical center and large community hospital. <h3>Patients.</h3> —Patients over age 18 years scheduled for elective primary total hip replacement were eligible. Of 254 patients interviewed, 232 were randomized, 220 patients had surgery and received prophylaxis, and 201 had venography. <h3>Interventions.</h3> —Patients were randomly assigned to prophylaxis with a device providing bilateral sequential EPC to both the calf and thigh or to receive warfarin in a low-intensity regimen beginning 10 to 14 days preoperatively. Prophylaxis was continued until venography. <h3>Main Outcome Measures.</h3> —Venous thrombosis was diagnosed by venography between postoperative days 6 and 8. Bleeding was assessed by surgical blood loss, transfusion requirements, changes in hematocrit, and clinically identified bleeding complications. <h3>Results.</h3> —The total incidence of venous thrombosis was virtually the same in the warfarin and EPC groups (31% vs 27%), but the distribution of thrombi was different. Proximal thrombosis occurred in 12% of patients in the EPC group compared with only 3% in the warfarin group (<i>P</i>=.012, 95% confidence interval for difference, 2% to 18%). In contrast, calf vein thrombosis was more frequent in the warfarin group (21%) than in the EPC group (12%) (<i>P</i>=.021,95% confidence interval for difference, 0% to 18%). Most proximal thrombi in EPC-treated patients were located within 15 cm of the femoral head and were not continuous with thrombi in deep calf veins. The high incidence of proximal thrombosis in the EPC group resulted in termination of the study by the safety monitoring committee. Blood loss and bleeding complications were similar in the two groups. <h3>Conclusion.</h3> —Warfarin therapy is significantly more effective than EPC in preventing serious proximal vein thrombosis after total hip replacement. The greater effectiveness of warfarin therapy in preventing proximal vein thrombi and of EPC in preventing thrombosis in the calf suggests that there are differences in the pathogenesis of thrombosis in these two locations. (<i>JAMA</i>. 1992;267:2911-2915)
Regulation of low density lipoprotein receptor activity in primary cultures of human hepatocytes by serum lipoproteins
Authors: Louis M. Havekes, Hans Verboom, Elly de Wit, Sing Hiem Yap, Hans M. G. Princen
Journal: Hepatology (1986)

The low density lipoprotein receptor activity was measured in primary cultures of human hepatocytes. The receptor-mediated association and degradation of low density lipoprotein increased gradually up to 140 and 190%, respectively, upon incubation of the cells with increasing amounts of whole serum (up to 100%). Preincubation of the cells with low density lipoprotein resulted in a weak downregulation of the receptor-mediated association of low density lipoprotein (only 35% reduction at 100 micrograms low density lipoprotein per ml). However, preincubation with high density lipoproteins with density between 1.16 and 1.20 gm per ml (heavy high density lipoprotein) resulted in a more than 2-fold stimulation of the receptor-mediated association of low density lipoprotein. This heavy high density lipoprotein-mediated stimulation could not be antagonized by a simultaneous addition of low density lipoprotein during that preincubation. We conclude that, in primary cultures of human hepatocytes, the downregulation of the low density lipoprotein receptor activity by low density lipoprotein is weak and completely overruled by heavy high density lipoprotein. If these results for human hepatocytes in vitro hold true for hepatocytes in vivo, our results might explain why in vivo liver cells still display low density lipoprotein receptor activity notwithstanding the exposure of these cells to physiological concentrations of low density lipoprotein.
In Vitro and In Vivo Evaluation of Oral Heparin–Loaded Polymeric Nanoparticles in Rabbits
Authors: Yuyan Jiao, Nathalie Ubrich, Monique Marchand-Arvier, Claude Vigneron, Maurice Hoffman, Thomas Lecompte, Philippe Maincent
Journal: Circulation (2002)

Background — Owing to its short half-life and lack of oral absorption, heparin has to be administered by the parenteral route. An oral heparin formulation, however, would avoid the disadvantages of parenteral injections and would consequently be highly desirable for patients. Polymeric nanoparticles (NPs) prepared with biodegradable poly-ε-caprolactone (PCL) and poly(lactic- co -glycolic acid) (PLGA) and nonbiodegradable positively charged polymers (Eudragit RS and RL), used alone or in combination, were evaluated in vitro and in vivo after a single oral administration of heparin-loaded NPs in rabbits. Methods and Results — After oral administration of heparin-loaded NPs in rabbits (600 IU/kg), increases in both anti–factor Xa activity and activated partial thromboplastin time (aPTT) were detected with each formulation. Moreover, the anti-Xa activity was detected for a longer period than when a heparin solution was administered intravenously. A peak concentration of 0.16±0.01 IU/mL and an average aPTT of 24 seconds (2-fold increase) were obtained 7 hours after oral dosing of Eudragit RL/PCL NPs containing heparin, exhibiting an absolute bioavailability of 23%. Conclusions — The significant increases in anti–factor Xa activity and aPTT confirmed the oral absorption in rabbits of heparin released from polymeric NPs.
UK adopts growth charts based on data from breastfed babies
Authors: R. Coombes
Journal: BMJ (2009)

All newborn babies and children up to 4 years old in the United Kingdom will have their growth measurements plotted on new charts from this week, which will lead to more infants classed as overweight or obese.

The UK is the first in Europe to adopt the new standards, based on World Health Organization data collected for breastfed babies. The charts replace those in use for nearly 20 years and which used measures based predominately on babies fed with formula milk.

All children, regardless of whether they are breast or bottle fed, will be plotted against the new standards. As breastfed babies grow at a slightly slower rate, the average weight of infants at the age of 1 year in the WHO chart is 1 kg less than in the …
John Peter Duffy
Authors: H. Duffy, M. Duffy
Journal: BMJ (2010)

John Peter Duffy was educated at St James’ Primary School, Renfrew, and St Mirren’s Academy, Paisley. After national service and working as a medical orderly, John entered Glasgow Medical School at the age of 21. In his undergraduate years he worked as a bus driver at weekends and met and married Helen Macalister, a fellow medical student. …
Hypertension Following Ornade Ingestion
Authors: Stanley Ostern
Journal: JAMA (1965)

<h3>To the Editor:—</h3> The Ornade Spansule (chlorpheniramine maleate, 8 mg; phenylpropanolamine hydrochloride, 50 mg; and isopropamide iodide, 2.5 mg), a widely-used orally administered antihistaminic-decongestant, has been reported to cause fever, thirst, drowsiness, tachycardia, "nervousness," insomnia, blurred vision, photophobia, dysphagia, disorientation, and increased menstrual flow.<sup>1</sup>It has not been generally known to cause hypertension in a previously normotensive individual. A 20-year-old oriental man was brought to the emergency room complaining of a severe bilateral occipital headache on both sides of 20 minutes' duration. He was in a moderately disoriented, agitated state and was rolling about the bed, holding his head. On physical examination his blood pressure was 220/120 mm Hg, pulse rate, 110 beats per minute, temperature 96 F (35.6 C). His pupils were slightly dilated but equal and reacted to light; he had marked photophobia. Funduscopic examination resulted in normal findings. There was marked spasm of the paravertebral musculature