tbuckley/cabot-search huggingface dataset:
Indications for Tonsillectomy
Authors: J. Finer
Journal: BMJ (1963)

<b>1097</b> <h3><b>Background:</b></h3> Functional imaging with 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography(PET/CT) is increasingly used for diagnosis and staging and restaging of breast cancer (BC) patients. <h3><b>Purpose:</b></h3> To evaluate the validity of 18F-FDG PET/CT metabolic activity parameter maximum standardized uptake value of the primary tumor (SUVmax-T) to predict locoregional axillary lymph node metastasis (ALNM) in initial staging of BC patients. <b>Materials and Methods:</b> We prospectively studied 40 female patients with different stages pathologically proven breast cancer. All patients were submitted to 18F-FDG PET/CT imaging for their initial tumor staging. The SUVmax-T and SUVmax ALN on 18F-FDGPET/CT were assessed. The patients were categorized into two groups; group I, with positive ALN uptake, and groupII with negative ALN uptake, according to the presence of locoregional 18F-FDG ALN uptake on visual &amp;quantitative analysis of 18F-FDG PET/CT. The correlations and differences between two groups were statistically evaluated. The optimal cut-off value of SUVmax-T was determined. <h3><b>Results:</b></h3> Forty female patients with newly diagnosed BC were included in our study, age range from 31-78 (mean 50.5 +/- SD11.7). All the 1ry tumors were detected with mean SUVmax 10.8(+/-SD 7.9). In the Twenty-Three patients who underwent nodal staging (axillary dissection in 7/23 patients and SLNBs in 16/23 patients.), 13/23 and 10/23 patients were positive and negative for metastases respectively.PET/CT was positive in 27 patients with ALNs; out of them 13 proved true positive, 4 were false positive by histopathology and in the remaining 10 cases no pathology report was available. PET/CT negative axillary cases were 13 out of them 6 were true negative by histopathology and in the remaining 7 cases no pathology report were available. The mean tumor size in group I was significantly greater than that in group II (3.1+/- SD 1 , P value 0.011). The mean SUVmax-T value in group A was significantly higher than that in group B ((Mean 12.7+/- SD 8.6 ,Pvalue 0.016). Tumor stage &amp;nuclear grade in group A was higher than that in group B (P value 0.372, 0.252 respectively). SUVmax -T were significantly moderately positively correlated with the size of the 1ry tumor (<b>rho</b>= 0.328, P value=0.019 . SUVmax -T was predictive of axillary nodal involvement AUC= 0.735(95% CI: 0.577-0.893). The optimal cut-off of SUVmax-T for detecting ALNM was&gt;1.9 gives sensitivity 100% and specificity 92%. with overall sensitivity and specificity of PET/CT for axillary staging was 100 % and 60 %, respectively (P value= 0.006). <h3><b>Conclusions:</b></h3> BC patients with higher FDG SUVmax of primary tumor are at greater risk of concurrent ALNM. Keywords: Breast cancer. FDG PET/CT . SUVmax. Initial staging. Axillary lymph nodal metastasis, prognosis.
A new trend in cholera epidemiology.
Authors: S. Mukerjee, S. Basu, P. Bhattacharya
Journal: BMJ (1965)

A new phase in the epidemiology of cholera has become evident since 1961, when cholera El Tor, which was originally confined to a limited geographical area in the Celebes Island in Indonesia for several decades, emerged from its original home and spread extensively in the West Pacific region and South and South-east Asian countries.The world incidence of cholera, which had been progressively declining during the last few decades, is again showing a tendency to increase.Since 1923 classical cholera, caused by Vibrio cholerae, has been confined to a few countries in Asia, and from 1962 it has remained limited in India and Pakistan; whereas cholera El Tor, caused by El Tor vibrios, still continues its spread over wide areas in a pandemic form.The chronological order of spread of El Tor infection since 1961 is shown in the accompanying map.Cholera El Tor appeared in Burma in 1963, and, spreading further westwards, reached Chittagong in East Pakistan by the end of 1963.Its entry into India was first detected in Calcutta in April 1964(Mukerjee, 1964).Before the end of the year cholera El Tor was found to have spread to seven districts of East Pakistan and West Bengal.In Calcutta cases of El Tor infection soon outnumbered those classical cholera.From July 1964 scattered areas in Bihar state, from which only V. cholerae strains had been isolated during the first half of the year, showed cholera infections due exclusively to El Tor vibrios.During the middle of 1964 El Tor vibrios were isolated in almost equal proportion with V. cholerae from outbreaks in Surat and Baroda areas in Gujratt state on the western coast of India.In the first three months of 1965 only El Tor vibrios were isolated from cholera cases in Baroda.During the latter half of 1964 the city of Bombay was found to harbour cholera vibrios of both types, which were isolated from patients suffering from diarrhoea after the cholera epidemic of 1964 was over.In the Kottayam area in Kerala, on the other hand, El Tor cultures alone could be isolated from cases during the cholera outbreaks in 1965.A small epidemic of " acute gastro-enteritis" in Ujjain and other places around Indore, in
Skin autofluorescence, a marker for advanced glycation end product accumulation, is associated with arterial stiffness in patients with end-stage renal disease
Authors: Hiroki Ueno, Hidenori Koyama, Shinji Tanaka, Shinya Fukumoto, Kayo Shinohara, Tetsuo Shoji, Masanori Emoto, Hideki Tahara, Ryusuke Kakiya, Tsutomu Tabata, Toshio Miyata, Yoshiki Nishizawa
Journal: Metabolism (2008)
TRANSPLANTATION OF UNPURGED AUTOLOGOUS BONE-MARROW IN ACUTE MYELOID LEUKAEMIA IN FIRST REMISSION
Authors: A.K. Burnett, R. Watkins, D. Maharaj, S. Mckinnon, P. Tansey, M. Alcorn, C.R.J. Singer, G.A. Mcdonald, A.G. Robertson
Journal: The Lancet (1984)
Effect of a Novel Pancreatic Stent Design on Short-Term Pancreatic Injury in a Canine Model
Authors: G. Raju, G. Gomez, S. Xiao, I. Ahmed, D. Brining, M. Bhutani, A. N. Kalloo, P. Pasricha
Journal: Endoscopy (2006)

Background and Study Aims: Attempts to address the problem of injury to the pancreas by indwelling pancreatic stents are limited by our lack of knowledge of the pathogenesis of stent-induced injury and its relationship to stent morphology and the duration of stenting. The aim of our study was to evaluate pancreatic injury induced by 1 week of stenting with a 5F indwelling pancreatic stent of novel design, the "wing stent." Methods: Pancreatic stents (5F) were placed surgically in eight dogs; wing stents (WS-5F) were used in four dogs and conventional stents (CS-5F) in another four. Two dogs underwent duodenotomy without stent placement (controls). The pancreas was harvested for microscopy at 1 week. A pathologist who was unaware of the source of the specimens graded the pancreatic injury. Results: Although pancreatic injury was observed in both the CS-5F and WS-5F groups after 1 week of indwelling pancreatic stenting, it was considerably less severe in the WS-5F group compared with the CS-5F group (1.01 ± 0.10 vs. 1.63 ± 0.14, P < 0.01). All components of pancreatic injury were affected, with the most dramatic differences noted in inflammation, fibrosis, and edema. The differences were most marked in the stented segment (P < 0.001) and in the upstream segment of the pancreas (P < 0.05). Conclusions: Indwelling conventional pancreatic stents can cause significant pancreatic injury even when left in place for only 1 week. A wing design can significantly ameliorate stent-induced changes.
Complex interventions: how “out of control” can a randomised controlled trial be?
Authors: Penelope Hawe, Alan Shiell, Therese Riley
Journal: BMJ (2004)

Complex interventions are more than the sum of their parts, and interventions need to be better theorised to reflect this 

Many people think that standardisation and randomised controlled trials go hand in hand. Having an intervention look the same as possible in different places is thought to be paramount. But this may be why some community interventions have had weak effects. We propose a radical departure from the way large scale interventions are typically conceptualised. This could liberate interventions to be responsive to local context and potentially more effective while still allowing meaningful evaluation in controlled designs. The key lies in looking past the simple elements of a system to embrace complex system functions and processes.

The suitability of cluster randomised trials for evaluating interventions directed at whole communities or organisations remains vexed.1 It need not be.2 Some health promotion advocates (including the WHO European working group on health promotion evaluation) believe randomised controlled trials are inappropriate because of the perceived requirement for interventions in different sites to be standardised or look the same.1 3 4 They have abandoned randomised trials because they think context level adaptation, which is essential for interventions to work, is precluded by trial designs. An example of context level adaptation might be adjusting educational materials to suit various local learning styles and literacy levels.

Lead thinkers in complex interventions, such as the UK's Medical Research Council, also think that trials of complex interventions must “consistently provide as close to the same intervention as possible” by “standardising the content and delivery of the intervention.”5 By contrast, however, they do not see this as a reason to reject randomised controlled trials.

These divergent views have led to problems on two fronts. Firstly, the field of health promotion is being turned away from randomised …
Submucosal Hematoma Producing Mechanical Obstruction in the Sigmoid Colon, Complicated by Systemic Amyloidosis
Authors: T. Yoshida, H. Kanbe, Y. Haraguchi, A. Sakamoto, T. Iwashita, K. Tanaka, T. Katsuki
Journal: Endoscopy (1983)

A case of systemic amyloidosis involving the gastrointestinal tract is presented. The initial manifestation of this case was mechanical obstruction. On laparotomy, a submucosal hematoma of the sigmoid colon which completely obliterated the lumen, was found.
ANG mutations segregate with familial and 'sporadic' amyotrophic lateral sclerosis
Authors: Matthew J Greenway, Peter M Andersen, Carsten Russ, Sean Ennis, Susan Cashman, Colette Donaghy, Victor Patterson, Robert Swingler, Dairin Kieran, Jochen Prehn, Karen E Morrison, Andrew Green, K Ravi Acharya, Robert H Brown, Orla Hardiman
Journal: Nature Genetics (2006)
Angioplasty vs Bypass Surgery in Patients With Multivessel Coronary Artery Disease-Reply
Authors: Robert Frye
Journal: JAMA (1997)

In Reply.  —Drs Guerra and Viswanath question the relevance to current practice of our findings from the BARI study of higher repeat revascularization rates in patients assigned to PTCA vs those assigned to CABG. It is possible, based on the findings from STRESS trials,1,2that stent use could have reduced the need for repeat revascularization in diabetic patients in the BARI trial. However, even if stents had been available in the BARI, it seems highly unlikely based on the STRESS results that rates of repeat revascularization would have been similar for patients who received CABG or PTCA.  In the STRESS trials, the reported rate of fi-month target lesion revascularization (repeat PTCA or CABG) among patients who received stents was 13%.2This rate was only 2% in BARI patients assigned to CABG. Thus, despite a markedly worse baseline profile, including more extensive coronary disease, BARI patients who initially received CABG had
Symptoms of possible oncological significance: separating the wheat from the chaff
Authors: N. Summerton
Journal: BMJ (2002)

Symptoms are a common experience for all humans and are rarely synonymous with a particular disease. In the United Kingdom people are often encouraged to consult their general practitioner, and general practitioners are often advised to refer patients to secondary care according to the presence of one or more symptoms. Much of the evidence for this is based on the patterns of symptoms in patients with serious or important illnesses that are encountered by specialist clinicians.1 The discriminant value of a symptom is related not only to the specific properties of that symptom but also to the characteristics of the setting and the population encountered.2 An urgent requirement exists for attendance and referral practices to be based on data generated from epidemiological studies of symptoms in community settings.

Failing to respond to potentially serious illness accurately and efficiently can have adverse consequences for the delivery of high quality …
Control of hydatid disease in Wales
Authors: S R Palmer, A H Biffin, P S Craig, T M Walters
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objectives</b>: To evaluate the success of the south Powys hydatid control programme by analysis of trends in cystic disease in humans and sheep and dog infestation. <b>Design</b>: A review of hospital admissions for human hydatid disease in 1984-90, abattoir prevalence surveys of hydatid cysts in adult sheep, arecoline acetarsol and coproantigen surveys of prevalence of Echinococcus infestation in dogs. <b>Setting</b>: All hospitals in England and Wales, three abattoirs, and dog populations in mid and south east Wales. <b>Subjects</b>: Residents of England and Wales admitted to hospital between 1984 and 1990 with a new diagnosis of human hydatid disease (International Classification of Diseases (ICD), ninth revision, code 122) acquired in the United Kingdom. <b>Results</b>: The average annual incidence of human hydatid disease in Powys, mid-Wales, fell from 3.9 x 10<sup>-5</sup> in 1974-83 to 2.3 x 10<sup>-5</sup> in 1984-90. Age specific incidence rates in Wales declined over this period only in children, and no cases occurred in children (&lt;15 years) in Powys. Two Welsh children who lived in Gwent and mid-Glamorgan were infected. Prevalence of hydatid cysts in old sheep from south Wales declined during the control period, but in 1993 prevalence of cysts was 13%. Prevalence of E granulosus infestation was zero in the control area in 1993, but it was 2.4% in Powys dogs outside the control area in 1989 and 9.2% in dogs in Gwent in 1991. <b>Conclusions</b>: Human hydatid disease has been successfully controlled in south Powys but cystic echinococcosis is still endemic in sheep in mid-Wales, and there is a focus of infection in humans, sheep, and dogs in the bordering areas of Gwent and mid-Glamorgan. There is considerable potential for an upsurge in human cases if control measures are relaxed. <h3>Key messages</h3> Humans are infected by ingesting eggs of the dog tapeworm, which the dog acquires by eating sheep offal containing hydatid cysts Regular dosing of dogs with praziquantel has eliminated infestation of dogs in the control area and reduced prevalence in sheep No cases in children occurred in Powys, but there were cases outside of the control area in Gwent and mid-Glamorgan Prevalence of hydatid cysts in old sheep in Powys and Gwent is still high and control measures must be continued and the control area extended
Safety and tolerability of onabotulinumtoxinA in the treatment of facial lines: A meta-analysis of individual patient data from global clinical registration studies in 1678 participants
Authors: Mitchell F. Brin, Terry I. Boodhoo, Janice M. Pogoda, Lynn M. James, George Demos, Yasunori Terashima, Juanhong Gu, Nina Eadie, Beta L. Bowen
Journal: Journal of the American Academy of Dermatology (2009)
Partial defect of neutrophil oxidative metabolism in Crohn's disease.
Authors: H W Verspaget, M A Mieremet-Ooms, I T Weterman, A S Pena
Journal: Gut (1984)

Polymorphonuclear leucocytes of patients with untreated Crohn's disease showed a lower level of oxidative metabolism than polymorphonuclear leucocytes of treated Crohn's disease patients and controls. Whereas the production of superoxide anion (O-.2) in Crohn's disease patients was almost normal, polymorphonuclear leucocytes of untreated Crohn's disease patients showed a significantly deficient production of hydrogen peroxide (H2O2). In the medically treated Crohn's disease patients, a significant negative correlation was found between H2O2 production by polymorphonuclear leucocytes and disease activity. These findings suggest an intrinsic cellular defect in the neutrophils of Crohn's disease patients which, together with the decreased locomotor function of these cells in vivo, might contribute to the pathogenesis of the chronic inflammation and granuloma formation in this disease.
Report sparks controversy over cause of children's psychiatric symptoms
Authors: K. McColl
Journal: BMJ (2008)

The purpose of this work was to determine the influence of variety, clarification type, fermentation temperature, and the addition of selected yeast on wines to obtain dry wines from grape must of Muscatel and Malvasia varieties. An experimental design was tried, based on 74 white wine samples identified through 19 analytical variables and submitted to analysis of variance (ANOVA), multivariate analysis of variance (MANOVA), and principal component analysis (PCA). The study is carried out with two varieties of white <i>Vitis vinifera</i> grapes (Muscatel and Malvasia) which are used in the production of Spanish white wine. The must was clarified following two different procedures (static decantation and membrane filtration) and later fermented at laboratory scale at three temperatures (15°C, 18°C, and 21°C) and two yeast types (D47 and K1M) were inoculated into the must. Significant differences were found according to grape variety, clarification, temperature, and yeast type when ANOVA and MANOVA were performed. The application of PCA to the data showed that differences between organic acids and higher alcohols are mainly due to the grape variety and the yeast type used for fermentations. With the results found, we propose the best conditions to obtain dry wines from Muscatel and Malvasia varieties.
Recombinant DNA: Science, Ethics, and Politics
Authors: William R. Barclay
Journal: JAMA (1979)

Among the many scientific discoveries that have occurred through the ages, a few have produced great technological advances, pronounced social changes, and entirely new perspectives on the world in which we live. Most of these discoveries have been in the fields of chemistry and physics, although a few have occurred in the biological sciences. Practically all such discoveries have been exploited and allowed to impact on society with minimum planning or regulation. Even the relationship between mass and energy and the use of this knowledge to produce energy from nuclear reactions has gone unregulated and unplanned, so we are now confronted with the awesome possibility of total destruction of all living creatures or, in another scenario, the failure to apply current technology to liberate our energy-starved societies. Certainly we must rank the deciphering of the genetic code and the ability to produce recombinant DNA as among the most remarkable discoveries
Professional and practice development plans for primary care teams
Authors: G. J. Elwyn
Journal: BMJ (1998)

The spread between the best and the worst of the 10 000 practices in the United Kingdom is wide. In a matter of minutes we can travel from paperless practices with integrated teams which have developed nurse practitioners, physiotherapy, and in house phlebotomy to those where the prescribing is suspect and the consultations perfunctory—all performed with the sole aids of prescription pads, sick notes, and unchecked sphygnomanometers. Like the gap between evidence and practice, there is a gap too between continuing medical education and professional and practice development.

Professional and practice development plans aim to fill that gap and are destined to replace the postgraduate education allowance. The concept is a direct result of the Chief Medical Officer's review of continuing professional development in general practice, which adds another surge of energy to the “corporate” rather than the “independent practitioner” vision of primary care. The review was a response to the criticism that the postgraduate education allowance has been based on an educational model which is “didactic, uni-professional and top-down,” rarely involves the …
Physician-Assisted Suicide — Oregon and Beyond
Authors: Susan Okie
Journal: New England Journal of Medicine (2005)

In February, the U.S. Supreme Court agreed to consider the legality of the Bush administration's effort to outlaw physician-assisted suicide in Oregon, raising the possibility that a ruling by the Court during its next term could effectively invalidate the controversial Oregon law known as the Death with Dignity Act. With the events leading to the death of Terri Schiavo focusing national attention on end-of-life decisions, the Court's acceptance of the case formerly known as Oregon v. Ashcroft is likely to heat up the public debate on assisted suicide. The justices will hear oral arguments in the case, now renamed Oregon . . .
Three-Dimensional Echocardiographic Estimation of Infarct Mass Based on Quantification of Dysfunctional Left Ventricular Mass
Authors: Jiefen Yao, Qi-Ling Cao, Navroz Masani, Alain Delabays, Giuseppina Magni, Philippe Acar, Cleo Laskari, Natesa G. Pandian
Journal: Circulation (1997)

Background Two-dimensional echocardiography is useful for estimating the extent of infarct-related wall motion abnormalities. Such estimation, however, is based on a few selected views and extrapolated for the whole left ventricle (LV). This approach does not provide us with the actual amount of dysfunctional myocardium. Volume-rendered three-dimensional echocardiography (3DE) might overcome these limitations. In this study we explored (1) how well volume-rendered 3DE delineates regional dysfunction of the infarcted LV and (2) how well dysfunctional myocardial mass quantified by 3DE reflects the actual anatomic infarct mass. Methods and Results 3DE was performed before and 3 hours after coronary occlusion in 16 dogs. With the LV viewed in equidistant short-axis slices, the region of dysfunction was demarcated, and the dysfunctional myocardial mass was derived from this. With triphenyltetrazolium chloride staining, anatomic infarct regions were delineated, dissected, and weighed. The anatomic infarct mass was 16.3±7.7 g (mean±SD) (range, 6.4 to 31.4 g); the dysfunctional mass estimated by 3DE was 17.4±9.1 g (range, 5.2 to 39.0 g). The mean difference was 1.0 g. The correlation between dysfunctional mass ( y ) and infarct mass ( x ) was y =1.1 x −0.6, r =.93 ( P &lt;.0001). The percentage of LV involved in infarction was 18.2±5.8% (range, 9.1% to 26.1%); the percentage of LV involved in regional dysfunction was 18.3±6.9% (range, 7.9% to 31.2%). The mean difference was 0.1%. The correlation between percentage of LV involved in infarction ( x ) and percentage of LV involved in dysfunction ( y ) was y =1.0 x −1.1, r =.92 ( P &lt;.0001). Conclusions Volume-rendered 3DE crisply displays regional dysfunction of infarcted LV. 3DE-measured dysfunctional mass accurately reflects the anatomic infarct mass.