tbuckley/cabot-search huggingface dataset:
Paternal age and schizophrenia: One swallow does not make a summer
Authors: Marco Procopio
Journal: BMJ (2005)

Users' guide to detecting misleading claims in researchMisleading claims may be symptom of even more serious flaws Editor-Montori et al justifiably draw attention to misleading claims in published clinical trials. 1 This is a serious and common problem. 2 3 However, I object to their radical proposal that only the methods and results sections should be read, while the remainder of the paper should be ignored.The proposal is inconsistent with the title of their paper, "Users' guide to detecting misleading claims in clinical research reports." 1 How are these misleading claims to be identified if the sections containing them are omitted?Furthermore, anyone capable of critically appraising a trial solely on the basis of the methods and results is unlikely to be fooled by misleading claims in the discussion.But, more importantly, the proposal would deprive the discerning reader of witnessing the conflict between the results and the unwarranted conclusions.If researchers are willing to disseminate misleading claims then their integrity is brought into question.But if so, then all aspects of the trial-including the methods and results sections-are also brought into question.Misleading claims should be identified and broadcast loudly for they signal doubts about the entire study.Large scale randomised trials create the ideal conditions for data manipulation.Yet this is merely one of a multitude of problems stemming from a flawed method. 3 The remedy?When reading a study, ignore everything except the number of patients recruited.If this is large proceed no further as there is little prospect of encountering any data of genuine benefit to patients.
Association between K469E allele of intercellular adhesion molecule 1 gene and inflammatory bowel disease in different populations
Authors: A Papa
Journal: Gut (2003)

We read with interest the article by Matsuzawa et al showing an association between the K469E allele of intercellular adhesion molecule (ICAM)-1 gene and inflammatory bowel disease (IBD) in a Japanese population ( Gut 2003; 52 :75–8). The ICAM-1 gene lies on chromosome 19p13, previously implicated in determining susceptibility to IBD,1 and codifies for a surface glycoprotein that belongs to the immunoglobulin superfamily. ICAM-1 plays an important role in the trafficking and activation of leucocytes and is upregulated in the inflamed mucosa of IBD patients. Matsuzawa et al found that the allelic frequency of K469 was significantly higher in both Crohn’s disease (CD) and ulcerative colitis (UC) patients than controls ( Gut 2003; 52 :75–8). These data are in contrast with the results of two previous studies from the USA2 and Germany3 which showed no significant difference in K469 allele frequency between IBD patients and healthy controls. The G241R polymorphism of the ICAM-1 gene was also investigated in these studies, and IBD patients were stratified by antineutrophil cytoplasmic antibody (ANCA) status. In particular, Yang …
Long term imatinib treatment in pulmonary arterial hypertension
Authors: R Souza
Journal: Thorax (2006)

Pulmonary arterial hypertension (PAH) is a life threatening condition characterised by progressive obliteration of the small pulmonary arteries leading to increased pulmonary arterial resistance and right heart failure. Treatment for PAH has developed in the last few years since the description of new pathways related to the disease.1 Recently, short term (6 months) use of imatinib, a platelet derived growth factor (PDGF) receptor antagonist, in combination with maximal PAH treatment (prostacyclin derivative, endothelin receptor antagonist, and type 5 phosphodiesterase inhibitor) has been shown to improve the haemodynamics and functional capacity in a single case of severe PAH.2 We here report the first two cases of the long term (3 years or more) use of imatinib, as monotherapy or in combination with bosentan, a dual endothelin receptor antagonist. …
Tumor necrosis factor-α–induced production of plasminogen activator inhibitor 1 and its regulation by pioglitazone and cerivastatin in a nonmalignant human hepatocyte cell line
Authors: Yumie Takeshita, Toshinari Takamura, Erika Hamaguchi, Akiko Shimizu, Tsuguhito Ota, Masaru Sakurai, Shuichi Kaneko
Journal: Metabolism (2006)
Glucose Tolerance During and After Pregnancy in Nondiabetic Women in an Urban Population in Tanzania
Authors: Janet K Lutale, Aafke Justesen, Andrew B M Swai, K George M M Alberti, Donald F McLarty
Journal: Diabetes Care (1993)

OBJECTIVE It is generally accepted that glucose tolerance deteriorates during pregnancy in the developed world. Several small studies have suggested that this may not be the case in sub-Saharan Africa. This study was designed to investigate changes in glucose tolerance in nondiabetic African women during pregnancy in Dar es Salaam, Tanzania. RESEARCH DESIGN AND METHODS Women (n = 89) seen before the 14th wk of pregnancy without known diabetes were recruited: 58 had a 75-g OGTT in the 1st, 2nd, and 3rd trimesters and postpartum. RESULTS Mean FBG levels were 3.9, 3.5, 3.6, and 3.7 mM in the 1st, 2nd, and 3rd trimesters and postpartum period, respectively. Values were significantly lower in the 2nd and 3rd trimesters than in the 1st and 2nd trimesters compared with postpartum. Mean 2-h blood glucoses were 4.7, 4.4, 4.3, and 4.2 mM, respectively. The 1st trimester value was significantly higher than in the 3rd trimester and postpartum. Fifteen (26%) of the 58 women showed a decreased or unchanged 2-h blood glucose during the course of pregnancy, 5 (9%) showed an increase, and no clear pattern was seen in 38 (67%). Values for fasting glucose showed similar trends. CONCLUSIONS We conclude that women during pregnancy in an urban African setting show little change in glucose tolerance. This contrasts with women in both the developed world, where glucose tolerance worsens, and in a rural African environment, where glucose tends to improve.
The antitumor function of tumor necrosis factor (TNF) II. Analysis of the role of endogenous TNF in endotoxin-induced hemorrhagic necrosis and regression of an established sarcoma.
Authors: R J North, E A Havell
Journal: The Journal of Experimental Medicine (1988)

In agreement with the results of previous studies (1), it was shown that intravenous injection of endotoxin into mice bearing 9-d SA1 sarcoma resulted in a tumor hemorrhagic reaction that rapidly caused necrosis of most of the center of the tumor, and then the complete regression of the rim of living tumor tissue that survived the hemorrhagic reaction. The tumor hemorrhagic reaction was confined to the vascular bed of the tumor, and its rate and extent of development were measured in terms of the intratumor extravasation of 51Cr-labeled syngeneic red cells. The development of the hemorrhagic reaction was associated with the presence in the tumor over a 6-h period of endogenous TNF that was measured in terms of its capacity to kill L929B cells in vitro and identified by its susceptibility to neutralization with a monospecific, polyvalent anti-rTNF antibody. The same antibody was capable in vivo of inhibiting the endotoxin-induced tumor hemorrhagic reaction by only approximately 50%, even when present in the tumor in excess. However, it was capable when given in the same quantity of inhibiting the ability of endotoxin to cause complete tumor regression. The fact that TNF was generated in the tumor during the tumor hemorrhagic reaction, and that infusion of a sufficient quantity of anti-rTNF antibody severely interfered with hemorrhagic necrosis and prevented tumor regression represents convincing evidence that TNF is an essential participant in endotoxin-induced regression of an established SA1 sarcoma. Moreover, because tumor regression, as opposed to hemorrhagic necrosis, failed to occur if the tumor was growing in immunoincompetent mice, but did so if the mice were infused with tumor-sensitized T cells, it can be concluded that an adequate level of T cell-mediated immunity is also an essential requirement for endotoxin-induced tumor regression. The participation of other endotoxin-induced mediators in tumor regression cannot be ruled out.
Philip John Kingston
Authors: J. Ropner
Journal: BMJ (2012)

Before he studied medicine, Philip John Kingston was in the navy and served on an aircraft carrier. This is presumably where he was exposed to asbestos, which resulted in the mesothelioma which eventually killed him.

Philip’s career in haematology began at St Thomas’ Hospital, where he was appointed as senior lecturer in 1975. In 1978 he was appointed as the first consultant haematologist in Gloucestershire, at what was then Gloucester Royal Hospital. He set up both the laboratory and clinical services. His prodigious energy and attention to detail were outstanding. He had extremely high standards and expected the same from those who worked with him. When clinical pathology accreditation inspections at laboratories started, these qualities were invaluable and woe betide anybody who had not done what was required of them. The inspectors rarely found anything negative to say about …
Intraoperative assessment of axillary lymph nodes in patients with breast cancer
Authors: J. M. Dixon, E. Rutgers, K. K. Hunt
Journal: BMJ (2014)

Time to abandon?

The main advantage of intraoperative assessment of axillary lymph nodes in patients having surgery for breast cancer is that metastatic disease can be diagnosed and removed in a single operation. However, there are several disadvantages that have cast doubt on its use. These include concerns about its accuracy and the uncertainty that all patients with diseased sentinel nodes need additional treatment.

Several methods have been used for intraoperative assessment of axillary nodes, including frozen section analysis, touch preparation cytology, and one step nucleic acid amplification. The National Institute for Health and Care Excellence (NICE) approved one step nucleic acid amplification in 2011, and it is the most widely used axillary staging method in the United Kingdom.1

A recent meta-analysis has raised doubts about the ability of one step nucleic acid amplification to accurately determine the extent of axillary node involvement.2 The method is based on the measurement of messenger RNA for cytokeratin 19, expression levels of which vary between and within cancers, with copy numbers ranging from 4700 to 140 000 copies per microlitre. The meta-analysis concluded that the wide range of copy numbers in a fixed tumour volume …
The effect of troglitazone on plasma homocysteine, hepatic and red blood cell S-adenosyl methionine, and S-adenosyl homocysteine and enzymes in homocysteine metabolism in Zucker rats
Authors: Vivian Fonseca, Mary Keebler, Aliza Dicker[ndash ]Brown, Cyrus DeSouza, Lionel A. Poirier, S.N. Murthy, Dennis B. McNamara
Journal: Metabolism (2002)
THE STREPTOCOCCI OF EQUINES
Authors: F. S. Jones
Journal: The Journal of Experimental Medicine (1919)

The lower nasal mucosa and the pharynx of thirty eastern and twenty-three western horses have been examined for streptococci. Eight of the eastern horses carried non-hemolytic streptococci on the nasal mucosa. From the pharynx of six, non-hepiolytic streptococci were cultivated. The throats of eighteen contained strains of the hemolytic type. The nasal mucosa of the eastern horses failed to show hemolytic streptococci. Eight western horses carried non-hemolytic streptococci in the nasal passage; eight also harbored the hemolytic type. Twenty-two strains were isolated from the pharynx. Eleven were hemolytic. Among all the non-hemolytic nasal strains those capable of fermenting mannite predominate. Those of the non-hemolytic types from the pharynx of both classes of horses may or may not ferment lactose but all do ferment either raffinose or inulin. In no instance have any of the non-hemolytic types proved pathogenic for mice. The hemolytic strains from the nasal mucosa of the western horses were all of the Streptococcus py genes type. They were pathogenic for mice and rabbits. One strain from the pharynx of an eastern horse and eight from the throats of the western horses were of the same species. All the others corresponded closely in their fermentation reactions with non-hemolytic streptococci from the same region. The streptococci from pathological sources were all hemolytic. They have fallen into two groups; the larger group (Streptococcus pyogenes) produced acid in dextrose, lactose, saccharose, maltose, milk, and salicin but failed to change the reaction of broth containing raffinose, inulin, or mannite. The streptococci of the smaller group (Streptococcus equi) differ only in their inability to ferment lactose or acidulate milk. Both types are pathogenic for mice. Rabbits are usually more resistant. Streptococcus pyogenes has been isolated from eighteen of twenty-two cases of influenza, three of six cases of strangles, and from eight of nine abscesses. Streptococcus equi was observed in four horses suffering from influenza and five others affected with strangles. This species was also found in an abscess and associated with both rhinitis and pharyngitis.
Registries and Registration of Clinical Trials
Authors: Charlotte Haug, Peter C. Gøtzsche, Torben V. Schroeder
Journal: New England Journal of Medicine (2005)

The arguments in favor of the registration of clinical trials are now familiar.14 Chief among these addresses the practice of selective reporting, whereby negative or detrimental studies are not brought into the public domain, which experts on the subject of clinical trials consider an important form of scientific misconduct.5 This practice, as illustrated in a number of high-profile examples, have increased the demand for the mandatory public registration of clinical trials. Registration of trials should improve the completeness, reliability, and quality of the interpretation of clinical research.This need for registration prompts the question of where trials should be . . .
Bad medicine: health promotion
Authors: Des Spence
Journal: BMJ (2012)

Research is flawed and open to the bias of the authors because people don’t invest time and energy to prove themselves wrong. So if research conclusions don’t make intuitive sense, it is prudent to question the validity of the research. So it is with the conclusions of research into health promotion, because I don’t believe that educating (that is, lecturing) patients to change lifestyle works. It is simply not how people operate. Patients are aware of risks but wantonly choose to ignore our advice. But governments ignore this: health promotion in England costs £3.7bn …
Hormone Production and Peptide Regulation of the Human Fetal Pituitary Gland*
Authors: J. JEFFREY MULCHAHEY, ANNA MARIA DiBLASIO, MARY C. MARTIN, ZEEV BLUMENFELD, ROBERT B. JAFFE
Journal: Endocrine Reviews (1987)

THE PREVALENT view of the ontogeny of neuroendocrine regulation of anterior pituitary secretion promulgated by Gluckman et al. (1), in an earlier review in this journal is that the development of this control is dependent upon maturation of the central nervous system. But by the time the central nervous system completes its synaptogenesis and other integrative systems of the developing human have reached a state of maturity competent to perform many of the tasks associated with homeostasis, the endocrine system will have been functional for some time. Thus, the endocrine system may be perceived not as mimicking that of the adult, but rather as one of the first, if not the first, homeostatic systems to develop, a system which is functional from intrauterine life through old age, but which may have unique functions during fetal life. As will be shown, the neuroendocrine axis appears early in fetal development, and the full repertoire of neurotransmitter, neuropeptide, and hormonal factors are available to regulate pituitary function early in gestation.
Medicinal Applications of Delta-9-Tetrahydrocannabinol and Marijuana
Authors: Eric A. Voth
Journal: Annals of Internal Medicine (1997)

The use of crude marijuana for herbal medicinal applications is now being widely discussed in both the medical and lay literature. Ballot initiatives in California and Arizona have recently made crude marijuana accessible to patients under certain circumstances. As medicinal applications of pure forms of delta-9-tetrahydrocannabinol (THC) and crude marijuana are being considered, the most promising uses of any form of THC are to counteract the nausea associated with cancer chemotherapy and to stimulate appetite. We evaluated the relevant research published between 1975 and 1996 on the medical applications, physical complications, and legal precedents for the use of pure THC or crude marijuana. Our review focused on the medical use of THC derivatives for nausea associated with cancer chemotherapy, glaucoma, stimulation of appetite, and spinal cord spasticity. Despite the toxicity of THC delivered in any form, evidence supports the selective use of pure THC preparations to treat nausea associated with cancer chemotherapy and to stimulate appetite. The evidence does not support the reclassification of crude marijuana as a prescribable medicine.
Invitation to Mexican Congress.THE INTERNATIONAL MEDICAL ASSOCIATION OF MEXICO.
Authors: R. D. Robinson
Journal: JAMA (1906)

Torreon, Coah., Mex., May 11, 1906. <h3>To the Secretary of the American Medical Association:</h3> On behalf of the members we have the honor to invite the members of the American Medical Association to be present at the second annual meeting of the International Medical Association of Mexico, which will take place in Mexico City in November next. Due notice of the exact date will be given. Hoping to have the pleasure of the company of many, if not all, members of the A. M. A., we have the honor to be, yours very truly,
Endoscopic ultrasound (EUS)-guided transduodenal drainage of an obstructed jejunal loop after hepaticojejunostomy as treatment for recurrent biliary sepsis
Authors: C. Jürgensen, R. Wentrup, M. Zeitz
Journal: Endoscopy (2013)

Hepaticojejunostomy is an established treatment for cholestasis. Complications arise due to obstruction of either the anastomosis or the efferent loop with risk of biliary sepsis. We present a novel approach, transduodenal interventional drainage guided by endoscopic ultrasound (EUS), used in two patients after unsuccessful antibiotic therapy. The first patient was a 76-year-old woman who developed recurrent biliary sepsis (Escherichia coli) 4 years after right hepatic trisectorectomy for cholangiocarcinoma with intra- and extrahepatic recurrence 6 months previously. The second patient was a 70-year-old man who also experienced recurrent episodes of biliary sepsis (Acinetobacter, Enterococcus) 16 months after surgery for cholangiocarcinoma (extended right hemihepatectomy) with peritoneal carcinomatosis 1 year later.
Hacmatemesis and Melaena
Authors: L. J. Witts
Journal: BMJ (1937)

Bartholomew's Hospital During the -last few years there has been much con- troversy over the treatment of bleeding from the stomach and duodenum.Should we operate and, if so, what operation should we do?Should we transfuse?Is morphine harmful?Should we feed or starve the patient?Should we give alkalis?Does any treatment at all favourably influence the mortality?What is the mortality?On none of these points is there general agreement, and the mass statistics which have been quoted have done little to clarify the issue.One is reminded of those barbarian hosts, numerous but inchoate, which again and.again throughout history have been routed by the discipline of a few.Though small in number, the results of a single physician, surgeon, or team who is actively interested in the disease and gives the patients individual attention and supervision are more valuable than a large assortment of cases, collected from different wards, or indeed different hospitals, and treated with very variable degrees of thoroughness.No well-informed person would try to assess the prog- nosis and treatment of diabetes mellitus or pernicious anaemia from mass hospital statistics.He knows that they inadequately reflect the benefits conferred by insulin and liver extract.For accurate information about these diseases he goes to the records of individual physicians such as Joslin or Wilkinson, so that he can be sure that the patients have received the appropriate treatment for their disease.In the same way, when discussing haema- temesis and melaena we should quote the best individual results of treatment, such as those of Finsterer (1936) and Meulengracht (1936), though we must at the same time decide whether these results are capable of general attain- ment.There is still need, then, for data about the prog- nosis of gastro-duodenal haemorrhage which bear the stamp of individual interest and treatment.A Fatal Case My own observations are based on a series of twenty- seven cases, which includes every patient with the pre- senting symptom of haematemesis, melaena, or conse- quent acute anaemia, whatever the cause of the gastro- duodenal bleeding, who has been admitted to the Medical Unit at St. Bartholomew's Hospital in the two years during which I have been in charge.For the intensive investigation of these patients I am indebted to my colleague Dr. F. Avery Jones.I shall have many occasions to refer to the analysis by Cullinan and Price (1932) of the 105 cases of severe haemorrhage from peptic ulcer, which were admitted to the medical wards of St. Bar- tholomew's Hospital between the years 1925 and 1929, an important paper which has not received the attention
Lack of Effect of Thyroxine in Patients with Graves' Hyperthyroidism Who Are Treated with an Antithyroid Drug
Authors: B McIver, P Rae, G Beckett, E Wilkinson, A Gold, A Toft
Journal: New England Journal of Medicine (1996)

Antithyroid drugs are effective in patients with hyperthyroidism due to Graves' disease, but the rate of recurrence after treatment is high. In a recent Japanese study, adjunctive treatment with thyroxine (T4) was associated with a recurrence rate 20 times lower than that among patients who received only an antithyroid drug. If these results are confirmed, combined therapy with an antithyroid drug and T4 might become the treatment of choice for all patients with Graves' hyperthyroidism.