tbuckley/cabot-search huggingface dataset:
Salt Balance and Long-Term Blood Pressure Control
Authors: A C Guyton, T G Coleman, D B Young, T E Lohmeier, J W DeClue
Journal: Annual Review of Medicine (1980)

Most of us are well aware of the many studies showing that segregated groups of people who live with meager intakes of salt usually maintain entirely normal blood pressures throughout their lives (1-4). At the other extreme, populations in which salt intake is greater than the norm have an especially high incidence of hypertension (5, 6). One of the most graphic examples of relationships between salt intake and blood pressure was recorded by Prior and his colleagues (1, 2): the natives living on the island of Pukapuka and some other Pacific islands have a daily salt intake many times less than that of persons living in the Western culture, and their arterial pressures do not increase as they age. Yet, many of these natives have migrated to New Zealand and have taken up the cultural and dietary habits of the European New Zealanders. Subsequently, these migrants expe­ rience an incidence of increasing arterial pressure similar to that in the other new Zealanders of different racial stock.
The Tools of Our Trade — Some Comments on Disease and Disorder
Authors: Howard M. Spiro
Journal: New England Journal of Medicine (1975)

MOST persons use tools whose functions are clear to them, but whose construction is beyond their understanding. On the simple side, I strike a safety match to light my cigar without the slightest idea what makes up the red tip or how the combination of matchbook and match works to make a flame. On the complex side, I use the "black box" of a hand calculator to balance my accounts; I have faith that the orange lights paradoxically so gay in the little window stand for the true facts, but how they get there I do not know, and sometimes . . .
THE DETERMINATION OF ANTIBODY TO GROUP A STREPTOCOCCAL POLYSACCHARIDE IN HUMAN SERA BY HEMAGGLUTINATION
Authors: Willard C. Schmidt, Dorothy J. Moore
Journal: The Journal of Experimental Medicine (1965)

A hemagglutination method employing tanned human O erythrocytes sensitized with purified Group A streptococcal polysaccharide has been developed to measure A polysaccharide antibody in antistreptococcal rabbit and human sera. The reaction of sensitized RBC with known Group A streptococcal rabbit antisera, inhibition of hemagglutination with A polysaccharide, and abolition of hemagglutination and hemagglutination-inhibition by exposure of polysaccharide antigen to A enzyme, which destroys the specific immunologic determinant of A carbohydrate, were utilized to demonstrate the specificity of this hemagglutinating system. The results of A polysaccharide antibody determinations on sera from normal persons, patients convalescent from streptococcal infection, and patients with non-suppurative streptococcal sequelae are presented.
Longitudinal predictors of airway responsiveness to distilled water: the role of atopy and maternal smoke exposure
Authors: M Studnicka, B Roithner, C Gartner, ST Weiss, M Neumann, T Frischer
Journal: European Respiratory Journal (1998)

Airway responsiveness is an objectively measurable clinical trait related to the presence of asthma. Although risk factors for this trait have been evaluated cross-sectionally, little is known about its longitudinal predictors. A population cohort of 539 children, aged 8 yrs at the start of follow-up, underwent 3-7 bronchial challenge tests spaced at 3-9 month intervals. Airway responsiveness was assessed by a single-step distilled water challenge. To investigate responsiveness as a continuous trait, the ratio of the postchallenge to prechallenge forced expiratory volume in one second was calculated. A child's repeated ratios were then regressed on the time of follow-up. The resulting child-specific regression coefficient was the outcome variable to assess longitudinal predictors of airway responsiveness (AR). Results were based on 2,267 repeated challenge tests, and indicated an overall decrease in responsiveness. Children with a diagnosis of asthma (mean+/-SD, longitudinal change in AR + yr(-1): -0.060+/-0.149), those with a positive skin-prick test (-0.018+/-0.106) and those with reported exposure to maternal smoking (-0.004+/-0.083) demonstrated increased airway responsiveness over time. All of these changes in airway responsiveness were found to be significant in multiple linear regression analysis (p&lt;0.05). Stratified analysis further indicated that the effect of maternal smoking was observed primarily in nonatopic children and was greatest at an exposure level of &gt; or =10 cigarettes x day(-1). In conclusion, atopy and exposure to maternal smoking can predict longitudinal change in childhood airway responsiveness.
Cardiac Toxicity of Aerosol Propellants
Authors: George J. Taylor
Journal: JAMA (1970)

The fluoroalkane gases used to propel aerosols were toxic to the hearts of 34 mice, sensitizing them to asphyxiainduced sinus bradycardia, atrioventricular block, and T-waue depression. Cardiac sensitization was rapid, long-lasting, and lethal. It also occurred in rats and dogs. The propellants are postulated to possess a spectrum of cardiotoxic effects capable, in various species, of causing bradyarrhythmias, tachyarrhythmias, or myocardial depression. In humans the cardiac toxicity of aerosol propellants, particularly during asphyxia, may be a cause of sudden death in youths who "turn on" by inhaling propellants and in patients with asthma who make excessive use of bronchodilator aerosols. To a degree presently unknown, cardiac toxicity, including arrhythmias, due to propellant inhalation may be a potential hazard to frequent users of pressurized aerosol dispensers.
Domestic Violence Victims in the Emergency Department
Authors: Wendy G. Goldberg
Journal: JAMA (1984)

Four hundred ninety-two male and female patients from a general hospital emergency department were surveyed to elicit information on the extent and nature of domestic violence among this population. The patient's emergency department medical records were also reviewed. Twenty-two percent of the patients identified themselves on the survey as domestic violence victims. New findings in the areas of medical classification, nature of the abusive relationship, and patients' perceived treatment needs contribute to refining the battered spouse syndrome and are helpful in planning therapeutic intervention. The authors conclude that domestic violence victims should be identified and offered assistance while in the emergency department and outline a crisis intervention plan. (<i>JAMA</i>1984;251:3259-3264)
Handheld computers in clinical practice:… and will appeal to new breed of general practitioners
Authors: David A Eso
Journal: BMJ (2004)

How electronic communication is changing health care Usability is main barrier to effective electronic information systemsEditor-Jadad and Delamothe celebrate "the return of the human" to health informatics in their editorial asking what's next for electronic communication and health care. 1 The question is not whether we need to merge human centred and technology centred approaches: the question is how to do it.If electronic resources are to improve health they have to be accessible, reliable, and usable.More than 80% of websites are currently not accessible by all, including most primary care trust and healthcare charity sites. 2 And according to our unpublished in-house survey, few electronic resources are subject to the rigour we would expect of reliable, evidence based publications, and many of the high quality resources that exist are prohibitively difficult to use in everyday practice.Usability concerns whether an information system is structured so that users can get an answer to fit their purpose.The solution to this problem is user centred design. 3So why isn't it happening in health care?In spite of considerable evidence that user centred design results in cost savings downstream, and a clear need to assess the usability of information systems, 4 the perception remains that it is too expensive.A good first step is the creation of effective, free tools that help us assess the usability of electronic resources quickly, such as our LIDA tool (www.minervation.com/downloads.html).These are needed to show where the problems are in resources that already exist.Once the usability problem has been identified and defined and both users and commissioners have been educated to expect better from information technology systems, momentum will be gathered towards genuinely high quality electronic information systems.
Two cheers for psychotherapy
Authors: Peter Tyrer
Journal: The Lancet (2014)

6 years ago I was lecturing in Spain about the treatment of common mental disorders. After giving my fairly standard account of the differences in short-term and long-term outcomes between psychological and drug treatments, I was approached at the interval by a colleague. "Is it really true", he asked, "in your country are you making psychological treatments available to everybody who needs them?" I confirmed this was correct, although it was still at a very early stage in the UK. "But how did you manage to do it?", he said, somewhat incredulously.
389 HCV INFECTED PATIENTS ARE “SPARED” FROM THE METABOLIC SYNDROME BUT NOT FROM INSULIN RESISTANCE
Authors: S. Ballestri, E. Violi, A. Lonardo, L.E. Adinolfi, L. Carulli, S. Lombardini, F. Scaglioni, M. Ricchi, G. Ruggiero, P. Loria
Journal: Journal of Hepatology (2009)
Treatment of Severe Pseudomonas Infections of the Bronchi
Authors: A. Pines, H. Raafat, G. M. Siddiqui, J. S. B. Greenfield
Journal: BMJ (1970)

Experience in treating 81 patients with severe bronchial infection with Pseudomonas aeruginosa is described. For those who were desperately ill high doses of intravenous carbenicillin (18g. or more daily) were successful, even when initial carbenicillin resistance was present. For those who were less desperately ill lower doses of carbenicillin together with high doses of gentamicin (given both intramuscularly and by aerosol) comprised the treatment of choice. Gentamicin alone or colistin gave little or no benefit and cannot be recommended.
Prioritization of Research Addressing Antipsychotics for Adolescents and Young Adults With Bipolar Disorder
Authors: Matthew J. Crowley, Douglas C. McCrory, Ranee Chatterjee, Jennifer M. Gierisch, Evan R. Myers, Kristine M. Schmit, Remy R. Coeytaux, Christoph U. Correll, Amy S. Kendrick, Gillian D. Sanders
Journal: Annals of Internal Medicine (2014)

Despite a paucity of high-quality evidence about benefits and harms, antipsychotic medication use among adolescents and young adults with bipolar disorder is increasing. The Patient-Centered Outcomes Research Institute tasked the Duke Evidence Synthesis Group with creating a prioritized agenda for research in this area that would incorporate the perspectives of relevant stakeholders. We identified a list of potential evidence gaps by reviewing existing literature and engaged a diverse group of 9 stakeholders to expand and refine this list. Using a forced-ranking prioritization method, stakeholders prioritized 10 of 23 potential evidence gaps as the most pressing for future research. These evidence gaps relate to 3 areas: the comparative effectiveness of intervention strategies, the effect of antipsychotics on patient-centered outcomes, and the influence of various patient characteristics on antipsychotic effectiveness. In addition to presenting these findings, we suggest appropriate study designs for addressing the stakeholder-prioritized research questions.
Doctors and nurses with HIV and AIDS in sub-Saharan Africa
Authors: Dan J Ncayiyana
Journal: BMJ (2004)

achievement. 4Evidence shows some self selection rooted in perceived discrimination, with able young people from lower socioeconomic groups ruling themselves out of medical school. 8vidence also shows differential career opportunity by ethnicity.Goldacre et al show differential distributions of doctors by ethnicity by specialty. 3In part this reflects the recruitment problems in some less popular specialties (for example, psychiatry, geriatric medicine), which lead trusts to recruit doctors from abroad.Some doctors from ethnic minorities develop careers in less popular specialties because they cannot advance in their chosen area.A study of genitourinary medicine doctors in the early 1990s found that the specialty was perceived as having a low status in medicine.Many of the overseas doctors in the study would have preferred a different career (notably in obstetrics and gynaecology) but found that they could not obtain a post. 9ow can we ensure that doctors in the NHS are drawn from across the United Kingdom's demographic spectrum?The number of places for medical students in the United Kingdom is being increased, and that, together with the policy of developing the roles and responsibilities of other healthcare professionals, may reduce recruitment of overseas doctors. 10ruly widening access to medical school is a challenge.A recent editorial, and the responses to it, identified a number of possible courses of action. 11The requirement for good science A levels (in particular, chemistry) restricts the pool of eligible applicants to medical school. 12More would be eligible if selection focused on overall academic ability and aptitude for practice, with opportunities to catch up on science during preclinical years.The diversity of applicants might be increased by more opportunities targeted at under-represented groups, especially those from lower socioeconomic groups.Alternative routes into medicine, such as fast track postgraduate medical training and foundation degrees aimed at other healthcare workers, could be increased.We need to be confident that access to medical careers in all specialties is open to all with ability, aptitude, and commitment.Once this is achieved we should have a medical workforce that broadly reflects the wide diversity of the population.
Some Experiments with Protamine Insulinate
Authors: R. D. Lawrence, N. Archer
Journal: BMJ (1936)

a" after the injection of p.entnucleotide 10 c,cm.This amount was given twice daily, and -when the patient was distressed -coramine was injected.-On July 24th there was again a blotchy eraption on the abdomen and lower part of the chest, and some exudate was seen on the posterior pharyngeal wall.The tongue and mouth were very dry and there was some diarrhoea.On the next day dysphagia was marked and the pulse became intermittent.On July 26th a small anal ulcer was seen.The throat sloughs were now very large, covering most of the fauces a,s before.On July 28th Cheyne-Stokes breath-ing was noticed when the patient was asleep.Much offensive sputum was coughed up, suggesting that sloughs were separating further down the pharynx and oesophagus.The report on the sputum was: " Direct examination shows epithelial cells, no pus, many Gram-positive and Gram-negative cocci.Cultures resulted in growths of the following organisms, the approximate per- centage of each being shown from a rough colony count: haemolytic Streptococcus longus, 1-0 per cent.; pneumo- coccus, 40 per cent.;Micrococcus catarrhtalis, 50 per cent."A second anal ulcer was observed on July 28th.By July 29th the patient was becoming increasingly weaker, the sclerotics appeared yellow, the sputum was foulsmelling and yellow in colour, and by 2 a.m. on July 30th she was semi-comatose; by 7 a.m.she was completely unconscious, and died at 1.30 p.m.The temperature rose to 106.60 F. before death.Examination of a blood film on July 29th showed that:" Many of the lymphocytes are larger than normal, with more cytoplasm, which stains more deeply than usual."Immediately after death the patient became a vivid yellow colour, with purple patches beginning in the face and continuing down the limbs and all over the body.
Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum
Authors: N. Bhandari
Journal: BMJ (2002)

<h3>Abstract</h3> <b>Objectives:</b> To evaluate the effect of daily zinc supplementation in children on the incidence of acute lower respiratory tract infections and pneumonia. <b>Design:</b> Double masked, randomised placebo controlled trial. <b>Setting:</b> A slum community in New Delhi, India. <b>Participants:</b> 2482 children aged 6 to 30 months. <b>Interventions:</b> Daily elemental zinc, 10 mg to infants and 20 mg to older children or placebo for four months. Both groups received single massive dose of vitamin A (100 000 IU for infants and 200 000 IU for older children) at enrolment. <b>Main outcome measures:</b> All households were visited weekly. Any children with cough and lower chest indrawing or respiratory rate 5 breaths per minute less than the World Health Organization criteria for fast breathing were brought to study physicians. <b>Results:</b> At four months the mean plasma zinc concentration was higher in the zinc group (19.8 (SD 10.1) <i>v</i> 9.3 (2.1) μmol/l, P&lt;0.001). The proportion of children who had acute lower respiratory tract infection during follow up was no different in the two groups (absolute risk reduction −0.2%, 95% confidence interval −3.9% to 3.6%). Zinc supplementation resulted in a lower incidence of pneumonia than placebo (absolute risk reduction 2.5%, 95% confidence interval 0.4% to 4.6%). After correction for multiple episodes in the same child by generalised estimating equations analysis the odds ratio was 0.74, 95% confidence interval 0.56 to 0.99. <b>Conclusions:</b> Zinc supplementation substantially reduced the incidence of pneumonia in children who had received vitamin A.
Antihypertensive treatment in pregnancy
Authors: L W Doyle, M. A Quinn
Journal: BMJ (1985)

are inconclusive, but Chamberlain et al have shown that chronically hypertensive women who do not get pre-eclampsia can expect a normal perinatal outcome.3It therefore seems a pity that all the authors' patients have been grouped together and that there is no separate analysis according to the severity of the hypertension.Some of their patients seem to have been overtreated, and this would limit the validity of their conclusions on the benefit of oxprenolol in pregnancy.
Participation of Health Care Personnel in Torture and Interrogation
Authors: Philip R. Lee, Marcus Conant, Steve Heilig
Journal: New England Journal of Medicine (2005)

To the Editor: The profession of medicine has developed codes of ethical conduct over thousands of years. A central element of such codes is expressed in the imperative to “do no harm.” Disclosures with regard to the treatment of detainees by licensed medical personnel in the “war on terror” in Iraq, Afghanistan, and Guantanamo Bay, Cuba, have revealed undeniable breaches of medical ethics among U.S. military health care personnel involved at these — and perhaps other — sites.1 The International Red Cross has charged that some of the physical and emotional tactics used constitute cruel and unusual punishment. The Geneva . . .
Research in Cystic Fibrosis
Authors: Paul A. Di Sant'Agnese, Pamela B. Davis
Journal: New England Journal of Medicine (1976)

Tissue-Culture StudiesMetachromasiaThe earliest observations of differences between cystic-fibrosis and normal cells were made by Danes and Bearn,54 who noted metachromasia, a staining property produced by interaction of a cationic dye with negatively charged macromolecules, in most lines of heterozygote and homozygote fibroblasts, but only rarely in normal fibroblasts. They distinguished two morphologic types and, in addition, a small group of families with cystic fibrosis whose cells are ametachromatic. All these various types "breed true."15 These findings provided the first objective suggestion that phenotypically similar patients might, in fact, be genetically heterogenous. However, these authors . . .
Race and Medicine in Nineteenth- and Early-Twentieth-Century America
Authors: Lynn C. Smitherman
Journal: JAMA (2007)

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REPORT OF CASES OF TUBERCULOSIS TREATED WITH ANTIPHTHISIC SERUM T.R. (FISCH).
Authors: F. E. WAXHAM
Journal: JAMA (1898)

The attention of the profession having been quite generally called, of late, to the serum treatment of tuberculosis and some rather glowing reports having been made I desire to add my conclusions, drawn from a limited number of cases. Through the courtesy of the John T. Milliken Co., I was early provided with their antiphthisic serum T.R. (Fisch), which has been described in previous papers published in theJournal. I confess to have entered upon the treatment of tuberculosis with this serum with much confidence. The great value of antitoxin in the treatment of diphtheria inspired the hope that a serum for tuberculosis would prove equally effective. How well this confidence was placed must be judged from the following cases: <h3>Cass 1.</h3> —C. E. M., aged 40, first consulted me Oct. 26, 1895, and gave the following history: He had la grippe in 1894, after which his cough, which had