tbuckley/cabot-search huggingface dataset:
P58 The Characterisation and Subjective Assessment of Cough in Lung Cancer and Mesothelioma: The “CLAIM” Study
Authors: J Burnham, O Buffin, F Blackhall, J Smith, A Harle
Journal: Thorax (2013)

<h3>Introduction</h3> Lung cancer (LC) and mesothelioma (M) are usually terminal, with poor 5-year survival. Therefore, symptom control is crucial. Cough is a significant problem with physical, psychological and social consequences. It has a broad aetiology and its physiological mechanisms remain unclear. Methods for its assessment are unreliable and available treatments are limited; the absence of valid quantification of cough prevalence and impact hinders the development of novel therapies. CLAIM evaluates the impact and prevalence of cough in LC and M using validated assessment tools. <h3>Methods</h3> Consecutive outpatients attending two cancer centres over a 5 week period completed the Manchester Cough in Lung Cancer Scale (MCLCS) and a cough severity visual analogue scale (VAS). Demographic and clinical data were collected. <h3>Results</h3> Patients were of advanced age (LC mean 66years, M mean 71years), predominately male (LC 54.9%, M 75.0%), with advanced disease (advanced non-small-cell LC 80.5%, extensive small-cell LC 71.4%). Those on treatment largely received palliative treatment (LC 89.7%, M 100%). The majority of patients were performance status ≥2 (LC 51.7%, M 60%). Cough was reported by 58% of LC patients (n = 224) and 43% of M patients (n = 60); painful cough was reported by 23% and 18%, respectively. LC and M patients felt their cough warranted treatment in 53% and 40% of cases. Cough was associated with breathlessness (LC 61.9%, M 63.6%), disrupted sleep (LC 47.8%, M 52.4%) and interrupted conversations (LC 64.6%, M 59.1%). There were moderate-strong correlations between MCLCS and VAS scores in all patient groups [non-small-cell (r = 0.68), small-cell LC (r = 0.66) and mesothelioma (r = 0.71), all p &lt; 0.01]. <h3>Conclusions</h3> This is the first study comparing the prevalence and impact of cough in LC and M using validated cough-specific assessment tools, in a clinically representative population. Cough is common in these cancers and has marked effects on quality of life. In the absence of evidence-based treatments, it represents an unmet clinical need. The high prevalence of cough in M is counterintuitive, in view of the tumour location. The MCLCS and VAS correlations suggest these are complementary tools which perform reliably in these disease groups.
Use of survival analysis to determine the clinical significance of new Q waves after coronary bypass surgery.
Authors: B R Chaitman, E L Alderman, L T Sheffield, T Tong, L Fisher, M B Mock, R D Weins, G C Kaiser, D Roitman, R Berger, B Gersh, H Schaff, M G Bourassa, T Killip
Journal: Circulation (1983)

There are few data on the long-term effects of new Q waves on survival and morbidity after coronary bypass graft surgery (CABG). We followed 1340 patients who underwent CABG in 1978 at 10 hospitals participating in the Coronary Artery Surgery Study (CASS). The incidence of perioperative Q-wave infarction was 4.76% (range 0.0-10.3% by hospital). The rate of infarction was higher in patients who had an increased left ventricular end-diastolic pressure or cardiomegaly on the preoperative chest radiograph. Patients who received more grafts or who had longer cardiopulmonary bypass time were also at higher risk of infarction. In a stepwise discriminant analysis of 44 clinical, angiographic and surgical variables, cardiopulmonary bypass time, topical cardiac hypothermia and cardiomegaly entered the stepwise selection of variables. Long-term survival was adversely affected by the appearance of new postoperative Q waves. The hospital mortality was 9.7% in the 62 patients who had new postoperative Q waves and 1.0% in the 1278 patients who did not (p less than 0.001); the 3-year cumulative survival rates were 85% and 95%, respectively (p less than 0.001). In patients who survived to hospital discharge, the presence of new postoperative Q waves did not adversely affect 3-year survival (94% and 96%, respectively). The survival rates were worse in patients who had a history of infarction or who had impaired left ventricular function preoperatively. The number of readmissions to hospital after CABG among the patients who had a transmural perioperative infarction was similar to to that among patients who did not. We conclude that the appearance of new Q waves after CABG adversely affects survival. The major impact on mortality occurs before hospital discharge. Patients who are destined to have a perioperative infarct cannot be predicted from commonly measured preoperative and angiographic variables.
Diffuse, Gastrointestinal Tract Motor Abnormality
Authors: Frank J. Gallia
Journal: JAMA (1968)

Dr. Reginald E. Greene: This 60-year-old woman was admitted to the hospital five years previously because of one year's duration of progressive muscular weakness of the legs associated with Raynaud's phenomenon. She also complained of epigastric burning which occurred when she was in the recumbent position. Electromyographic studies showed changes consistent with polymyositis. She was placed on a regimen of prednisone. Three years later she returned to the hospital because of increasing constipation, which required laxatives. A malabsorption syndrome subsequently developed with profuse diarrhea, decrease in serum albumin, and edema. A barium study at that time showed decreased motility in the distal portion of the esophagus. After this, the constipation recurred and was severe. Subcutaneous nodules developed about one year later. At the time of the present admission she complained of severe abdominal pain. Physical examination revealed a markedly tender, distended abdomen. Dr. Dreyfuss has been asked to discuss this
Metabolic and renal changes in two athletes during a world 24 hour relay record performance.
Authors: R A Irving, T D Noakes, R van Zyl Smit
Journal: British Journal of Sports Medicine (1989)

Metabolic parameters and renal function were studied in two subjects before, during and after they established a world two-man 24 hour relay record. During the race, the athletes expended an estimated 37.747 and 42.880 kJ running at 54 and 61 per cent of maximum oxygen consumption (VO2max). Rectal temperatures reached maxima of 38.6 and 39.2 degrees C respectively during the race. Serum free fatty acid levels peaked at 2108 and 1875 mumol ml-1 after 24 hours; blood glucose levels varied from 4.3-6.5 and 4.9-8.5 mmol.l-1 respectively. Plasma insulin levels fell from 42.9 and 22.7 microU.ml-1 to 11.5 microU.ml-1. Plasma urea, creatinine, beta 2-microglobulin and C-reactive protein concentrations were elevated at the end of the race (to 9.0 and 8.0 mmol.l-1, 119 and 102 mumol.l-1, 3.508 and 3203 micrograms.l-1 and 2.7 and 3.9 mg per cent respectively). Plasma osmolality was altered from 293 and 304 to 302 and 280 mosmol.Kg-1 during the race but increased to 312 and 318 mosmol.Kg-1 the following day probably due to intercompartmental fluid shifts. Plasma creatinine concentration was increased by 38 and 26 per cent due to reduced urinary excretion. Urine flow rate increased 40 and 123 per cent respectively during the race, but creatinine clearance decreased by 38 and 40 per cent. Urine osmolality decreased by 38 and 65 per cent and osmolal clearance decreased by 15 and 16 per cent respectively. Urine sodium excretion was greatly reduced (85 and 90 per cent) on the post-race days (by 88 and 92 per cent on day 2). Both urine total protein and beta2-microglobulin excretion increased during the race (by 89 and 35 per cent and by 334 and 136 per cent respectively), but owing to the increased beta2-microglobulin production renal clearance was unaltered. The changes in renal function were temporary and some aspects of renal tubular function were enhanced during the post-race days. We conclude that, although C-reactive protein concentrations increased sooner and were higher than other shorter events and although creatinine, urine excretion and urine osmolality decreased markedly, the intermittent nature of the event, the mild environmental conditions, the moderate percentage of VO2 max maintained by the well conditioned subjects and a high fluid intake enabled a rapid return to normality and indeed to enhanced renal tubular function. The only moderate increases in body temperature would be due to the same factors.
Immunogenetics of the Neonatal Lupus Syndrome
Authors: LELA A. LEE
Journal: Annals of Internal Medicine (1983)

Infants with neonatal lupus erythematosus have congenital heart block, transient cutaneous lesions, or both. Mothers of these infants have SSA/Ro autoantibodies that are passed across the placenta to the fetus and that have been temporarily associated with the syndrome. Six families with neonatal lupus were studied by HLA typing. All seven infants had transient cutaneous lesions, congenital heart block, or both. Five of six mothers were asymptomatic and one had Sjögren's syndrome. Six of seven infants and all six mothers had antibodies to SSA/Ro in their sera. The infants became seronegative by age 8 months. Five mothers were positive for HLA-DR3, five for HLA-MB2, six for HLA-MT2, and six for HLA-B8. No HLA associations were seen in infants. Gene products of the DR or similar regions may be associated with autoantibody production but not with other events in tissue injury.
Dislocation of Carpus Backwards
Authors: T. H. Morton
Journal: BMJ (1895)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Dislocation of Carpus Backwards Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Ciprofloxacin plus Vancomycin vs Ceftazidime plus Gentamicin in the Treatment of Pneumonia in Granulocytopenic Patients
Authors: V. Krčméry, P. Fuchsberger, J. Trupl, J. Šufliarsky, S. Špánik, I. Koza, Z. Kusenda, Š. Korec, J. Švec, P. Ďurkovič, J. Lakota, M. Horníková
Journal: Drugs (1993)
Spironolactone and Its Main Metabolite, Canrenoic Acid, Block Human Ether-a-Go-Go–Related Gene Channels
Authors: Ricardo Caballero, Ignacio Moreno, Teresa González, Cristina Arias, Carmen Valenzuela, Eva Delpón, Juan Tamargo
Journal: Circulation (2003)

Background— It has been demonstrated that spironolactone (SP) decreases the QT dispersion in chronic heart failure. In this study, the effects of SP and its metabolite, canrenoic acid (CA), on human ether-a-go-go–related gene (HERG) currents were analyzed. Methods and Results— HERG currents elicited in stably transfected Chinese hamster ovary cells were measured with the whole-cell patch-clamp technique. SP decreased HERG currents in a concentration-dependent manner (IC 50 =23.0±1.5 μmol/L) and shifted the midpoint of the activation curve to more negative potentials (Vh=−13.1±3.4 versus −18.9±3.6 mV, P &lt;0.05) without modifying the activation and deactivation kinetics. SP-induced block (1 μmol/L) appeared at the range of membrane potentials coinciding with that of channel activation, and thereafter, it remained constant, reaching 24.7±3.8% at +60 mV (n=6, P &lt;0.05). CA (0.01 nmol/L to 500 μmol/L) blocked HERG channels in a voltage- and frequency-independent manner. CA at 1 nmol/L shifted the midpoint of the activation curve to −19.9±1.8 mV and accelerated the time course of channel activation (τ=1064±125 versus 820±93 ms, n=11, P &lt;0.01). The envelope of the tail test demonstrated that at the very beginning of the pulses to +40 mV (25 ms), a certain amount of block was apparent (31.3±9.9%). CA did not modify the voltage-dependence of HERG channel inactivation (Vh=−60.8±5.6 versus −62.9±3.1 mV, n=6, P &gt;0.05) or the kinetics of the reactivation process at any potential tested. CA and aldosterone also blocked the native I Kr in guinea-pig ventricular myocytes. Conclusions— At concentrations reached after administration of therapeutic doses of SP, CA blocked the HERG channels by binding to both the closed and open states of the channel.
Henry Alfred Milne
Authors: J. Milne
Journal: BMJ (2014)

Henry Alfred Milne (“Bob”) graduated as a mature student in 1952, after five years as a pilot in the Royal Air Force during the second world war, where he completed two tours of ops in torpedoes, carrying a survival rate of just 3%. After his graduation from St Mary’s, Paddington, his first job was as house surgeon to Mr Dickson-Wright, the last of the …
National Registry for Drug-Induced Ocular Side Effects
Authors: F. T. Fraunfelder
Journal: JAMA (1977)

<h3>To the Editor.—</h3> The Food and Drug Administration has established a national registry for possible drug-induced ocular side effects. This is the first registry of this kind for any specialty group and is endorsed by the Ophthalmic Section of the American Academy of Ophthalmology and Otolaryngology. I would like to encourage all physicians suspecting a possible drug-induced ocular change to send such suspicions or case reports to this registry. Cases of greatest interest are those previously unsuspected, rare, severe, or unusual drug-related ocular side effects. If enough suspicion is aroused with a particular drug, a prospective study could be done. When reporting cases, the following data is most helpful: (1) suspected drug and reaction; (2) age and sex of the patient; (3) route, dosage, course of treatment, other drugs taken at the same time, and physician's opinion of cause and effect relationship; (4) physician's name and address (optional). The Privacy
C/EBP beta regulation of the tumor necrosis factor alpha gene.
Authors: R M Pope, A Leutz, S A Ness
Journal: Journal of Clinical Investigation (1994)

Activated macrophages contribute to chronic inflammation by the secretion of cytokines and proteinases. Tumor necrosis factor alpha (TNF alpha) is particularly important in this process because of its ability to regulate other inflammatory mediators in an autocrine and paracrine fashion. The mechanism(s) responsible for the cell type-specific regulation of TNF alpha is not known. We present data to show that the expression of TNF alpha is regulated by the transcription factor C/EBP beta (NF-IL6). C/EBP beta activated the TNF alpha gene promoter in cotransfection assays and bound to it at a site which failed to bind the closely related protein C/EBP alpha. Finally, a dominant-negative version of C/EBP beta blocked TNF alpha promoter activation in myeloid cells. Our results implicate C/EBP beta as an important regulator of TNF alpha by myelomonocytic cells.
CT scanner to become neurosurgical tool
Authors: Phil Gunby
Journal: JAMA (1983)

Very soon, in a historical area of New York's Bellevue Hospital Center where 1956 Nobelists Andre F. Cournand, MD, and Dickinson W. Richards, Jr, MD, once worked, another chapter in medical history may begin. A computed tomography (CT) scanner designed for intraoperative neurosurgical use is being installed for use in animal studies that are expected to lead to its rapid application to clinical neurosurgery.  This surgical CT scanner is one of three being developed for Scien-Tex Corp, Los Angeles. At the XII Symposium Radiologicum in Washington, DC, Cesare Giorgi, MD, explained that after the first one is in operation at the New York University (NYU) Medical Center-affiliated Bellevue, the second will be placed in the Instituto Neurologico Carlo Besta, Milan, where he is an assistant neurosurgeon. Any modifications proposed after evaluation by the multidisciplinary teams in New York and Milan will be incorporated into the third prototype scanner.  The new
Umbilical vein oxytocin for the treatment of retained placenta (Release Study): a double-blind, randomised controlled trial
Authors: Andrew D Weeks, Godfrey Alia, Gillian Vernon, Annette Namayanja, Radhika Gosakan, Tayyaba Majeed, Anna Hart, Hussain Jafri, Juan Nardin, Guillermo Carroli, Fiona Fairlie, Yasmin Raashid, Florence Mirembe, Zarko Alfirevic
Journal: The Lancet (2009)
Guidelines for the Clinical Diagnosis of Lyme Disease
Authors: Mark E. McCaulley
Journal: Annals of Internal Medicine (1998)

Letters1 September 1998Guidelines for the Clinical Diagnosis of Lyme DiseaseMark E. McCaulley, MDMark E. McCaulley, MDSteamboat Medical Group; Steamboat Springs, CO 80487Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-5-199809010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The position paper on laboratory diagnosis of Lyme disease [1] is based on a widely accepted paradigm that is inconsistent with a growing body of medical literature. According to this paradigm, cases of Lyme disease are overwhelmingly seropositive and are unlikely to be associated with persistent symptoms after presumed adequate therapy. In addition, any patients remaining persistently symptomatic are presumed to no longer have Lyme disease at all but rather to have such conditions as fibromyalgia, depression, or the chronic fatigue syndrome and, as a result, to be unlikely to respond to additional antibiotic therapy [2]. Such ...References1. Guidelines for laboratory evaluation in the diagnosis of Lyme disease. American College of Physicians. Ann Intern Med. 1997; 127:1106-8. Google Scholar2. Steere AC, Taylor E, McHugh GL, Logigian EL. The overdiagnosis of Lyme disease. JAMA. 1993; 269:1812-6. Google Scholar3. Shadick NA, Phillips CB, Logigian EL, Steere AC, Kaplan RF, Berardi VP, et al. The long-term clinical outcomes of Lyme disease. Ann Intern Med. 1994; 121:560-7. Google Scholar4. Mouritsen CL, Wittwer CT, Litwin CM, Yang L, Weis JJ, Martins TB, et al. Am J Clin Pathol. 1996; 105:647-54. Google Scholar5. Nocton JJ, Dressler F, Rutledge BJ, Rys PN, Persing DH, Steere AC. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in synovial fluid from patients with Lyme arthritis. N Engl J Med. 1994; 330:229-34. Google Scholar Author, Article, and Disclosure InformationAuthors: Mark E. McCaulley, MDAffiliations: Steamboat Medical Group; Steamboat Springs, CO 80487 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoExhaled Nitric Oxide and Impaired Oxygenation in Cirrhotic Patients before and after Liver Transplantation Giovanni Rolla , Luisa Brussino , Paola Colagrande , Ermanno Scappaticci , Mara Morello , Serena Bergerone , Antonio Ottobrelli , Elisabetta Cerutti , Salvatore Polizzi , and Caterina Bucca Metrics Cited byRoutine diagnosis of Borrelia burgdorferi (sensu lato) infections using a real-time PCR assayPharmaceutical economics & health policy 1 September 1998Volume 129, Issue 5Page: 422-423KeywordsAntibioticsAntigensBorrelia burgdorferiChronic fatigue syndromeDNAEnzyme linked immunosorbent assayFibromyalgiaLyme diseasePolymerase chain reactionResearch laboratories ePublished: 15 August 2000 Issue Published: 1 September 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Cardiologist is cleared of mistreating patients but criticised for research conduct
Authors: C. Dyer
Journal: BMJ (2010)

An “accomplished” interventional cardiologist who was accused of letting irresponsible ambition and personal conceit over-ride his duty to his patients has been cleared of misconduct in his treatment of patients.

But Joseph Motwani, a consultant at Derriford Hospital in Plymouth, carried out two clinical trials in an “inadequate, careless, and unethical” manner, a General Medical Council fitness to practise panel has ruled.

Dr Motwani’s fitness to practise was not impaired, the panel held, but it imposed a formal warning over “serious failings” in his research conduct that will remain on his entry on the medical register for five years. The warning …
Metabolic Consequences of Obesity
Authors: WALTER M. BORTZ
Journal: Annals of Internal Medicine (1969)

The obese individual is obviously different from his lean counterpart. He is different physically and constitutionally. It has been widely speculated that some of the metabolic changes seen in the obese may be causally significant in the production of the obesity. Recent work requires a review of the metabolic alterations seen in obesity. Such review indicates characteristic change in hormone activities and substrate levels in obesity. Further refined studies have indicated more precise details of the turnover and oxidative behavior of the metabolites—and their intimate interrelationships. This report interprets the composite literature on this subject to indicate that the obese individual, in the fed circumstances, is primed for starvation. That is, his metabolic adaptations are such as to make him more capable of withstanding the abrupt withdrawal of food. Such an inference has teleologic implications. Furthermore, it is felt that the alterations in metabolic behavior seen in obesity are resultants and not causal determinants of it.
Liver transplantation after paracetamol overdose.
Authors: C M Florkowski, R E Ferner, A F Jones
Journal: BMJ (1991)

made in table VII (that is, 13 surgeons by three types of operations and all operations together).Thirdly, no data are given to show whether or not survival is improved when surgery is done by specialists because, as the authors say, none of the surgeons specialised in this type of surgery.Furthermore, the postoperative mortality and complication rates for the four consultants with over 40% oftheir operations performed by surgeons in training were no worse than those for the other surgeons.Fourthly, comparing the hazard rates in the 10 years after surgery ignores the possibility that factors influencing postoperative mortality may well differ from those influencing longer term mortality.For example, postoperative mortality may be related to the technical skill of the surgeon, but longer term mortality might be related more to the surgeon's choice of procedure influenced by the patients' likely prognosis.Reporting large variability based on relatively small numbers resembles the situation on referral rates of general practitioners some time ago.Such studies had reported 20-fold variation in rates.Concern about this forms part of the government's justification for NHS reforms.'These studies were, however, based on small numbers of referrals and much of the variability could be attributed to random variation.4Later studies involving larger numbers of referrals found significant but much smaller variations in referral rates.4The paper by Messrs McArdle and Hole raises the important issue of significant variation in patients' outcome among surgeons.In our opinion there is insufficient adequate data and statistical back up to justify their conclusions.Further studies involving many more patients are required.