tbuckley/cabot-search huggingface dataset:
The Effect of Alternative Graphical Displays Used to Present the Benefits of Antibiotics for Sore Throat on Decisions about Whether to Seek Treatment: A Randomized Trial
Authors: Cheryl L. L. Carling, Doris Tove Kristoffersen, Signe Flottorp, Atle Fretheim, Andrew D. Oxman, Holger J. Schünemann, Elie A. Akl, Jeph Herrin, Thomas D. MacKenzie, Victor M. Montori
Journal: PLoS Medicine (2009)

Background We conducted an Internet-based randomized trial comparing four graphical displays of the benefits of antibiotics for people with sore throat who must decide whether to go to the doctor to seek treatment. Our objective was to determine which display resulted in choices most consistent with participants' values. Methods and Findings This was the first of a series of televised trials undertaken in cooperation with the Norwegian Broadcasting Company. We recruited adult volunteers in Norway through a nationally televised weekly health program. Participants went to our Web site and rated the relative importance of the consequences of treatment using visual analogue scales (VAS). They viewed the graphical display (or no information) to which they were randomized and were asked to decide whether to go to the doctor for an antibiotic prescription. We compared four presentations: face icons (happy/sad) or a bar graph showing the proportion of people with symptoms on day three with and without treatment, a bar graph of the average duration of symptoms, and a bar graph of proportion with symptoms on both days three and seven. Before completing the study, all participants were shown all the displays and detailed patient information about the treatment of sore throat and were asked to decide again. We calculated a relative importance score (RIS) by subtracting the VAS scores for the undesirable consequences of antibiotics from the VAS score for the benefit of symptom relief. We used logistic regression to determine the association between participants' RIS and their choice. 1,760 participants completed the study. There were statistically significant differences in the likelihood of choosing to go to the doctor in relation to different values (RIS). Of the four presentations, the bar graph of duration of symptoms resulted in decisions that were most consistent with the more fully informed second decision. Most participants also preferred this presentation (38%) and found it easiest to understand (37%). Participants shown the other three presentations were more likely to decide to go to the doctor based on their first decision than everyone based on the second decision. Participants preferred the graph using faces the least (14.4%). Conclusions For decisions about going to the doctor to get antibiotics for sore throat, treatment effects presented by a bar graph showing the duration of symptoms helped people make decisions more consistent with their values than treatment effects presented as graphical displays of proportions of people with sore throat following treatment. Clinical Trials Registration ISRCTN58507086 Please see later in the article for the Editors' Summary
Inactivation of HIV by Povidone-iodine
Authors: Paul D. Goldenheim
Journal: JAMA (1987)

<h3>To the Editor.—</h3> In a Letter to the Editor, Schuster et al<sup>1</sup>suggested that iodophors such as povidone-iodine (Betadine) can "reasonably" be expected to inactivate human immunodeficiency virus (HIV), also known as human T-cell lymphotrophic virus type III. The authors urged that compounds such as iodophors, which are "used almost universally for personal and patient disinfection," be evaluated for eradication of HIV before turning attention to ionizing radiation and other agents. In response to Schuster and colleagues as well as to many other infection control practitioners who have shown a continuing and extensive interest in this topic, we supported an in vitro study that evaluated the use of Betadine solution (10% povidone-iodine) and Betadine surgical scrub (7.5% povidone-iodine) in the inactivation of HIV. The study was conducted in the Infectious Disease Unit of Massachusetts General Hospital, Boston, by Robert T. Schooley, MD, and associates and was recently completed. (The
Management of pleural sepsis in Nigerian children.
Authors: C H Anyanwu, M Egbue
Journal: Thorax (1981)

Pleural sepsis in children is common in most developing countries. It may present as total pyothorax, pyopneumothorax, or localised thoracic empyema. In most cases, it follows an attack of bronchopneumonia, but other debilitating conditions such as measles, malnutrition, and sickle cell anaemia form part of the clinical syndrome. In a review of 60 cases of pleural sepsis in children aged between 1.5 months and 16 years, there were 40 cases of pyothorax, 15 of pyopneumothorax, and five of localised empyema. Treatment with chemotherapy only was given in 22 cases of whom eight died. Twenty-three patients had chemotherapy and tube drainage of the pleural contents; five died. Fifteen children had excision of the pleural disease, and decortication of the lung; none died. In view of the chronicity of the pleural sepsis by the time the child is seen in the hospital, and also the low mortality and shorter period in hospital, thoracotomy and decortication is recommended as the treatment of choice.
T helper type 1 and 17 cells determine efficacy of interferon-β in multiple sclerosis and experimental encephalomyelitis
Authors: Robert C Axtell, Brigit A de Jong, Katia Boniface, Laura F van der Voort, Roopa Bhat, Patrizia De Sarno, Rodrigo Naves, May Han, Franklin Zhong, Jim G Castellanos, Robert Mair, Athena Christakos, Ilan Kolkowitz, Liat Katz, Joep Killestein, Chris H Polman, René de Waal Malefyt, Lawrence Steinman, Chander Raman
Journal: Nature Medicine (2010)
Sulphonamide Chemotherapy in Gonorrhoea
Authors: H. M. Hanschell
Journal: BMJ (1938)

The ligand binding pocket of biogenic amine G protein-coupled receptors is embedded in the membrane-spanning regions of these receptors, whereas the extracellular domains of the peptidergic receptors play a key role in the structure and function of this class of receptors. To examine the role of the extracellular sequences in prostaglandin receptor-ligand interaction, chimeras were constructed with the two G<sub>s</sub>-coupled E-prostanoid (EP) receptors, replacing each of the extracellular sequences of the human EP<sub>2</sub>receptor with the corresponding human EP<sub>4</sub> receptor residues. Replacement of the third extracellular loop (ECIII) yielded a receptor that binds [<sup>3</sup>H]prostaglandin E<sub>2</sub>(PGE<sub>2</sub>; <i>K</i><sub>d</sub> = 6.3 nM) with similar affinity as the EP<sub>2</sub> wild-type receptor (<i>K</i><sub>d</sub> = 12.9 nM). Similarly, replacement of the nonconserved carboxyl-terminal portion of ECII resulted in a receptor that maintains [<sup>3</sup>H]PGE<sub>2</sub> binding (<i>K</i><sub>d</sub> = 8.8 nM). In contrast, replacement of the amino terminus, ECI, the entire ECII region, or the residues within the highly conserved motif of the amino-terminal half of ECII yielded chimeras that displayed neither detectable [<sup>3</sup>H]PGE<sub>2</sub> binding nor receptor-evoked cAMP generation. Immunoprecipitation demonstrated that each chimera is expressed at levels near that of wild-type receptors; however, enzyme-linked immunosorbent assay revealed that inactive chimeras have reduced cell surface expression. Similarly, chimeras that exchange the multiple extracellular loop sequences N/ECI, ECII/ECIII, or all four sequences lacked detectable binding and signal transduction, and although expressed, were not detected on the cell surface. These data suggest that the extracellular sequences of the EP<sub>2</sub>receptor are critical determinants of receptor structure and/or function, unlike other G protein-coupled receptors that bind small molecules.
A misrepresentation of reality
Authors: N. Jayasinghe
Journal: BMJ (2009)

The misrepresentative article by a Tamil national with a highly biased point of view that favours the propaganda of the Liberation Tigers of Tamil Eelam (LTTE) seems to have the objective of tarnishing the image of Sri Lanka among BMJ readers worldwide.1

Its accusation that “successive governments have used access to medicines as a weapon of war against the Tamils” is false and factually wrong. Sri Lanka’s free government sponsored healthcare system …
Access to urban acute care services in high- vs. middle-income countries: an analysis of seven cities
Authors: Shamly Austin, Srinivas Murthy, Hannah Wunsch, Neill K. J. Adhikari, Veena Karir, Kathryn Rowan, Shevin T. Jacob, Jorge Salluh, Fernando A. Bozza, Bin Du, Youzhong An, Bruce Lee, Felicia Wu, Yen-Lan Nguyen, Chris Oppong, Ramesh Venkataraman, Vimalraj Velayutham, Carmelo Dueñas, Derek C. Angus
Journal: Intensive Care Medicine (2013)

Cities are expanding rapidly in middle-income countries, but their supply of acute care services is unknown. We measured acute care services supply in seven cities of diverse economic background.In a cross-sectional study, we compared cities from two high-income (Boston, USA and Paris, France), three upper-middle-income (Bogota, Colombia; Recife, Brazil; and Liaocheng, China), and two lower-middle-income (Chennai, India and Kumasi, Ghana) countries. We collected standardized data on hospital beds, intensive care unit beds, and ambulances. Where possible, information was collected from local authorities. We expressed results per population (from United Nations) and per acute illness deaths (from Global Burden of Disease project).Supply of hospital beds where intravenous fluids could be delivered varied fourfold from 72.4/100,000 population in Kumasi to 241.5/100,000 in Boston. Intensive care unit (ICU) bed supply varied more than 45-fold from 0.4/100,000 population in Kumasi to 18.8/100,000 in Boston. Ambulance supply varied more than 70-fold. The variation widened when supply was estimated relative to disease burden (e.g., ICU beds varied more than 65-fold from 0.06/100 deaths due to acute illnesses in Kumasi to 4.11/100 in Bogota; ambulance services varied more than 100-fold). Hospital bed per disease burden was associated with gross domestic product (GDP) (R (2) = 0.88, p = 0.01), but ICU supply was not (R (2) = 0.33, p = 0.18). No city provided all requested data, and only two had ICU data.Urban acute care services vary substantially across economic regions, only partially due to differences in GDP. Cities were poor sources of information, which may hinder their future planning.
Open heart surgery in patients receiving chronic haemodialysis.
Authors: E McGovern, R Rooney, M C Neligan
Journal: Thorax (1984)

Chronic haemodialysis in the past was considered a con- traindication to major heart surgery.In 1968, however, Lansing' recorded the first successful valve replacement in a patient on haemodialysis and in 19742 and 19753 initial experience with coronary artery bypass grafting in such patients was reported.In view of the fact that more patients are having long term dialysis and that the incidence of coronary heart disease and infective endocarditis is higher than average in this group of patients, it can be expected that greater numbers will become candidates for major heart surgery in the future.We describe our experi- ence with two patients and discuss the management of their problems.
Pneumothorax as a complication of ESD
Authors: C. Jang, D. Park, K. Kwon, S. Yu, Y. Kim
Journal: Endoscopy (2007)

Endoscopic submucosal dissection (ESD) is a useful alternative to surgery for the treatment of selected cases of early gastric cancer (EGC) [1] [2] [3]. The two main complications associated with ESD are perforation and bleeding.
Diarrhea and Metformin in a Diabetic Clinic
Authors: Paresh Dandona, Vivien Fonseca, Anne Mier, Arthur G Beckett
Journal: Diabetes Care (1983)

In a questionnaire-based survey of 285 randomly selected diabetic patients, diarrhea was found to occur in 8%; this was found to be similar to that in 150 nondiabetic control patients attending other medical clinics (8%). When the diabetic patients were divided into separate therapeutic groups, metformin-treated (with or without sulfonylureas) patients had a markedly greater prevalence of diarrhea (20%) than those not on this drug (6%). A majority of patients with metformin-associated diarrhea had soiling of clothes as a problem, while at least two complained of frank loss of control over their anal sphincter. These patients did not have autonomic neuropathy, and in all who stopped this drug, diarrhea settled within 2-5 days. Only 6% of insulin-dependent diabetic individuals (IDD) had diarrhea, one of whom had explosive nocturnal stools with incontinence and features diagnostic of autonomic neuropathy. Metformin is by far the commonest cause of diarrhea and incontinence in our diabetic clinic, where it is used routinely. In contrast, diarrhea due to autonomic neuropathy is rare.
Repeated intravascular ultrasound imaging in cardiac transplant recipients does not accelerate transplant coronary artery disease
Authors: Kumudha Ramasubbu, Paul Schoenhagen, Mohammed A Balghith, Johannes Brechtken, Khaled M Ziada, Samir R Kapadia, Robert E Hobbs, Gustavo Rincon, Steven E Nissen, E.Murat Tuzcu
Journal: Journal of the American College of Cardiology (2003)
Angular Projection of the Spine, Successfully Treated
Authors: S. Hare
Journal: BMJ (1858)

CASE.Extremle Projection of the Spine of more than Four Years Duration: the Body bent at an Acute Angle on the Thighs, so that the Patient was unable to stand, except by resting his Hanzds antd Arims on his Knees: Effects of Treat- mnent.Robert, the son of Mr
The Medical Significance of Lenticular Opacities (Cataract) before the Age of Fifty
Authors: Richard J. Meyer
Journal: New England Journal of Medicine (1955)

THE association of presenile lenticular opacities (cataract) with various medical disorders has not received collective attention in the medical literature to date. Much has been written in the ophthalmologic literature in this regard and several excellent sources of information dealing with cataracts and their various classifications are available.1 2 3 4 5 6 Sorsby7 and Tassman8 have in textbook form each offered a complete treatise on the many ophthalmologic conditions encountered in systemic medical disease, and Igersheimer9 and more recently Kirby and Danforth10 have brought the subject of lens anomalies and cataract to the medical practitioner's attention. However, these particular publications do not deal primarily . . .
Abnormal sweat electrolytes in symptomatic human immunodeficiency virus infection in a child.
Authors: C H Skeoch, N A Coutts, K M Goel, E A Follett
Journal: BMJ (1987)

A 3 1/2 year old girl presented with failure to thrive and a five month history of diarrhoea and recurrent cough. The results of sweat sodium tests suggested a diagnosis of cystic fibrosis; but atypical organisms were found (Haemophilus influenzae, Candida albicans, but no Staphylococcus aureus), she failed to respond to treatment, and her sweat sodium concentrations fell in response to fludrocortisone. She also had hyperglobulinaemia, neutropenia, and reduced numbers of T4 lymphocytes, which prompted the performance of a test for antibody to human immunodeficiency virus (HIV). This proved positive, and she was treated with co-trimoxazole, zidovudine, and human immunoglobulin. Both parents and two siblings were also positive for HIV, though all had normal sweat sodium concentrations. Children with symptoms suggestive of cystic fibrosis but who also show atypical features, as in this case, should have their HIV state checked.
Swallowing is a precarious business
Authors: J A WILSON
Journal: Gut (1998)

See article on page537 

The upper oesophageal sphincter (UOS) remains closed at rest as a result of a combination of intrinsic muscle tone and passive pressure from the anterior mass of the larynx. This tonic activity is augmented during inspiration, thus preventing oesophageal air penetration each time intrathoracic pressure falls. UOS tonic pressure undergoes a further augmentation if the tubular oesophagus is distended—a protective reflex against oesophagopharyngeal regurgitation. Once oral preparation of an ingested bolus is complete, UOS tonic activity is abolished during the pharyngeal phase of a swallow. As the laryngopharynx elevates and shortens to engulf the bolus, the simultaneous forward tug of the rising hyoid on the anterior UOS wall brings about mechanical opening of the sphincter.

The nature of the deglutition reflex remains somewhat mysterious. The trigger to the onset of the ultra-rapid pharyngeal phase of swallowing is only semireflexive. All of us at times select the preferred moment of swallow—when we feel the bolus has been sufficiently chewed, when the social moment is right. Equally all of us have been caught out by the premature onset of a swallow reflex—when the bolus still feels too big to be swallowed, but seems to be escaping precipitately from the oropharynx. The elements of the swallow …
How Doctors Think: Clinical Judgement and the Practice of Medicine
Authors: Ross Kessel
Journal: Journal of the Royal Society of Medicine (2006)

Kathryn Montgomery's new book, How Doctors Think, addresses the thorny question of clinical judgement: of how doctors bring their knowledge and reasoning to bear on the problems of an individual patient, and how, even in this most technological of times, it remains essential to good medical practice. She explores what it is, how it is formed and taught, and the consequences of ignoring it in favour of a simplistic belief in medicine as merely another positivist science. She succeeds in bringing what Eric Cassell has called `steel' to the task, and she succeeds brilliantly.

If the outsider sees more of the game, then Kathryn Montgomery, who describes herself as a licensed trespasser on clinical territory, has a ringside seat. A literary scholar who has worked in medical schools all of her professional life, for the last twenty years as professor of medicine and director of the medical humanities program at North-western University, she has been observing doctors and doctoring for all that time. Throughout her book she uses her literary skill to show us what we do and how we do it and how that affects patients, families and ourselves. And always there are the stories; the narratives that bring her themes into sharp focus. Thus the opening section `Medicine as a Practice' draws heavily upon her own account, as the mother of a 28-year-old daughter diagnosed as having an invasive ductal carcinoma of the breast, to show how the limits of the knowledge we possess makes medicine, in so far as it is applied individually to single cases, more of a social than an exact science. Narrative too plays a crucial role in the two central sections of her book, `Clinical Judgement and the Idea of Cause' and `The Formation of Clinical Judgement'. Using doctors' aphorisms, maxims and rules of thumb, as well as patients' often inchoate `histories', she shows us how physicians arrive at a clinical judgement about the person in front of them; how they negotiate ambiguous alternatives and tolerate uncertain, or at least incomplete, answers and how reluctant they are to burden the vulnerable seeking certainty with the imprecision of their own knowledge.

The book's closing section, `Clinical Judgement and the Nature of Medicine', is perhaps the most challenging. Here Montgomery shows, with example after example, just why we should see medicine, not so much as a science but rather as situational reasoning serving a practical end; an endeavour based upon, but distinct from, medical science; the practical ability to select those pieces of knowledge that will determine what is best for this individual patient. Here, as she did in Doctors' Stories, she shows us just how discerning a skilled listener can be when faced with even the most seemingly trivial.

This is a book that will be read with pleasure by anyone interested in how medicine is done and it is a book that should be required reading for all students starting their clinical training.
Quantitation of basal dyssynchrony and acute resynchronization from left or biventricular pacing by novel echo-contrast variability imaging
Authors: Miho Kawaguchi, Taizo Murabayashi, Barry J. Fetics, Gregory S. Nelson, Hisanori Samejima, Erez Nevo, David A. Kass
Journal: Journal of the American College of Cardiology (2002)
AMPK in myocardial infarction and diabetes: the yin/yang effect
Authors: Amr Moussa, Ji Li
Journal: Acta Pharmaceutica Sinica B (2012)

There has been considerable progress in our understanding of cardiac cell metabolism in health and disease, yet important gaps remain in basic knowledge and its translation to clinical care. AMP-activated protein kinase (AMPK) functions either to conserve ATP or to promote alternative methods of ATP generation. Since the discovery of AMPK more than three decades ago and demonstration of its expression in the heart, interest has grown exponentially in this major fuel gauge as a modulator of the cellular response to ischemia. Such pathway may potentially explain the strong association between metabolic syndrome and ischemic heart disease. Still missing from our most recent cardiology textbooks, this article aims to summarize our understanding so far of the role of AMPK in coordinating the cellular response to ischemic stress and reperfusion injury in the heart. We aim to provide a focused update on the pharmacological agents activating AMPK for treatment of diabetes that show potential cardioprotective effects. Our hope is to stimulate future researchers to the potential benefits of harnessing the AMPK signaling pathway, or better one of its novel downstream targets for the treatment of myocardial ischemia.
Platelet Activation during Antigen-Induced Airway Reactions in Asthmatic Subjects
Authors: Kent A. Knauer, Lawrence M. Lichtenstein, N. Franklin Adkinson, James E. Fish
Journal: New England Journal of Medicine (1981)

CHEMICAL mediators derived from basophils or mast cells are considered to have an important role in the pathophysiology of asthma. Studies designed to document this relation, however, have provided inconsistent results. Some investigators have reported elevated plasma histamine levels associated with bronchoconstriction induced by exercise or inhaled antigen,1 , 2 but others have failed to confirm these findings.3 These discordant results may be explained in part by the reported variability in the accuracy of plasma histamine measurements by different laboratories.4 Neutrophil chemotactic factors have also been detected in the circulation after antigeninhalation challenge.3 , 5 Although neutrophil chemotactic factor appears to be a useful . . .