tbuckley/cabot-search huggingface dataset:
A CASE OF HAEMATOPORPHYRIA CONGENITA (CONGENITAL PORPHYRINURIA)
Authors: H. T. Ashby
Journal: BMJ (1924)

TiE child to be described first came u-nder niotice at the age of 12 months, anid the reasoni for the child being sent to the hospital was the dark red colour of the teetlh.The case was thieni thoroughly inlvestigated, anid proved to be an ex.amliple of haematopolphyria coiigeniita.Very few of tile CzIcses have as yet been i ecognized anid recorded so.early ill Efe.Sir A. E. Gairrod aind Mackey' report onie similar case, uimd I am indebted to the forn ci's book, Inborn Errors of MetabolismJ 2 for lielp.The child was apparently born healthy and had had no illness of noto.She hiad been easy to " bring up."All her life, however,
Evidence based diagnosis: Multiple tests with multiple responses are important
Authors: Ram Kumar
Journal: BMJ (2006)

Evidence based diagnosis We may need to be open to new ideasEditor-If evidence based diagnosis is still in the dark ages, as Delamothe writes, 1 then so is evidence based treatment.The doctor's job is to choose the right treatment.If the diagnosis is wrong then the treatment will be wrong.Inaccurate diagnoses will also affect clinical trials.A treatment may be "evidence based" because it has worked in a published study, but some patients who would have responded might have been left out because of diagnostic inaccuracy while some patients with no prospect of responding might have been included incorrectly. 2vidence based diagnosis is about convincing others using shared rules of evidence that a diagnosis (and its implications in terms of treatment) should be accepted by others.Evidence is gathered from the individual and from groups of patients. 3Evidence based diagnosis means specifying the individual's facts in addition to pointing to facts relating to that diagnosis in the literature. 4ayes's theorem uses unconditional initial prior probabilities.Diagnostic leads are based on conditional probabilities and are used to initiate diagnostic thought processes. 4owever, closely related theorems can be used to interpret diagnostic leads, which allow doctors to reason with diagnostic evidence in a more familiar way, 3 thus reducing misunderstandings. 5So to improve evidence based diagnosis we also need to collect better data on diagnostic leads.The published evidence given for a diagnosis and any related actions cannot realistically be assembled when actually seeing a patient.A draft evidence based rationale might be prepared in advance.It would have to be capable of being accessed in seconds to provide evidence in support of a suspected diagnosis and decision arrived at by using kindness, imagination, and common sense.It could be put into context by inserting the patient's details into the draft evidence summoned up from a computer.If we are to make progress and allow evidence based diagnosis to emerge from the dark ages then in addition to doing more of the same, we may also have to be receptive to new ideas.
Book Review Genetics and Public Health in the 21st Century: Using genetic information to improve health and prevent disease (Oxford Monographs on Medical Genetics. No. 40.) Edited by Muin J. Khoury, Wylie Burke, and Elizabeth J. Thomson. 639 pp. New York, Oxford University Press, 2000. $65. 0-19-512830-3
Authors: Mark A. Rothstein
Journal: New England Journal of Medicine (2000)
Medical Journals for German Doctors
Authors: J. P. S. Dunn
Journal: BMJ (1949)

<h3>Abstract</h3> Asexual reproduction has evolved repeatedly from sexual ancestors across a wide range of taxa. While the costs and benefits associated with asexuality have received considerable attention, the molecular changes underpinning the evolution of asexual reproduction remain relatively unexplored. In particular, it is completely unknown whether the repeated evolution of asexual phenotypes involves similar molecular changes, as previous studies have focused on changes occurring in single lineages. Here we investigate the extent of convergent gene expression changes across five independent transitions to asexuality in stick insects. We compared gene expression of asexual females to females of close sexual relatives in whole-bodies, reproductive tracts, and legs. We identified a striking amount of convergent gene expression change (up to 8% of genes), greatly exceeding that expected by chance. Convergent changes were also tissue-specific, and most likely driven by selection for functional changes. Genes showing convergent changes in the reproductive tract were associated with meiotic spindle formation and centrosome organization. These genes are particularly interesting as they can influence the production of unreduced eggs, a key barrier to asexual reproduction. Changes in legs and whole-bodies were likely involved in female sexual trait decay, with enrichment in terms such as sperm-storage and pigmentation. By identifying changes occurring across multiple independent transitions to asexuality, our results provide a rare insight into the molecular basis of asexual phenotypes and suggest that the evolutionary path to asexuality is highly constrained, requiring repeated changes to the same key genes.
The quality of health care in prison: results of a year's programme of semistructured inspections
Authors: J. Reed, M. Lyne
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objectives:</b> To assess, as part of wider inspections by HM Inspectorate of Prisons, the extent and quality of health care in prisons in England and Wales. <b>Design:</b> Inspections based on a set of "expectations" derived mainly from existing healthcare quality standards published by the prison service and existing ethical guidelines; questionnaire survey of prisoners. <b>Subjects:</b> 19 prisons in England and Wales, 1996-7. <b>Main outcome measures:</b> Appraisals of needs assessment and the commissioning and delivery of health care against the inspectorate9s expectations. <b>Results:</b> The quality of health care varied greatly. A few prisons provided health care broadly equivalent to NHS care, but in many the health care was of low quality, some doctors were not adequately trained to do the work they faced, and some care failed to meet proper ethical standards. Little professional support was available to healthcare staff. <b>Conclusions:</b> The current policy for improving health care in prisons is not likely to achieve its objectives and is potentially wasteful. The prison service needs to recognise that expertise in the commissioning and delivery of health care is overwhelmingly based in the NHS. The current review of the provision of health care in prisons offers an opportunity to ensure that prisoners are not excluded from high quality health care. <h3>Key messages</h3> The standard of health care in prisons in England and Wales varies widely—a few provide a quality of care close to that in the NHS, but many provide low quality care The commissioning of health care and the monitoring of services in prisons are inadequate More exacting standards for appointing doctors, a mandatory system for continuing professional development, and better support for healthcare staff are needed A better ethical framework is essential The NHS should be more involved in both the commissioning and the provision of health care in prisons
Cross-sectional early mitral flow-velocity profiles from color Doppler in patients with mitral valve disease.
Authors: S O Samstad, O Rossvoll, H G Torp, T Skjaerpe, L Hatle
Journal: Circulation (1992)

BACKGROUND Cross-sectional flow-velocity profiles from early mitral flow in 20 patients (10 with mitral regurgitation and 10 with mitral stenosis) were constructed from the velocity data from each point in sequentially delayed two-dimensional digital Doppler ultrasound maps. METHODS AND RESULTS The data suggested that the early mitral flow studied in an apical four-chamber view was variably skewed in both patient groups. The maximum flow velocity overestimated the cross-sectional mean velocity at the same time by a factor of 1.12-1.86. The maximum time-velocity integral was 1.13-1.77-fold greater than the cross-sectional mean time-velocity integral. In patients with mitral regurgitation, the cross-sectional flow-velocity profile appeared to be most skewed at the level of the mitral leaflet tips. The level of the mitral annulus appeared to give the most homogenous flow-velocity distribution in both patient groups. CONCLUSIONS When calculations of volume flow are based on pulsed Doppler ultrasound recordings with a single sample volume, the possibility of a skewed flow-velocity profile must be taken into account.
Psychiatrist is suspended for another 12 months after showing no reflection or remediation
Authors: C. Dyer
Journal: BMJ (2014)

A consultant psychiatrist who was suspended two years ago for refusing to examine or admit a mentally ill patient has been given another 12 months’ suspension after he told a panel of the Medical Practitioners Tribunal Service that he had acted correctly and would do the same again.

Sharaf Abd El Monem Salem was suspended for 12 months in December 2011 for multiple breaches of good practice in the case of “Patient A,” who was brought by a community mental health team to Bartholomew House, Goole, East Yorkshire, where Salem was the consultant responsible for managing inpatients. That suspension did …
Endothelial dysfunction in patients with sickle cell disease is related to selective impairment of shear stress–mediated vasodilation
Authors: Laurent Belhassen, Gabriel Pelle, Saı̈d Sediame, Dora Bachir, Claudine Carville, Catherine Bucherer, Catherine Lacombe, Frederic Galacteros, Serge Adnot
Journal: Blood (2001)
INTERNAL DERANGEMENTS OF THE KNEE-JOINT
Authors: H. Bramwell
Journal: BMJ (1918)

r D I589-infection of tinned food witlh B. botulinus.Moreover, certainly one of my patients has disclaimed ever having taken tinned food at all; and its relative infrequence among soldiers from abroad who have lived very largely on tinned food is significant.Prognosis and Treatment.It remains now to speak of the prognosis and treatment.In the majority of cases recovery occurs, though there is mwore, likelihood of a fatal termination in those cases of the 8uperior type; even here, lhowever, recovery may (uite unexpectedly take place.But what is of importance is that we. are able to hold out to the pationt's friends the possibility of recovery frQm a condition wllich, but for our knowledge of its nature,: we should othlerwise regard either as absolutely fatal or as the commeDcement of a chronic incurable disease, since different cases -may simulate cerebral tumour, tuberculous meningitis, or the onset of (lisseminate sclerosis.The recovery from paralysis may be incomnplete, as in poliom.yelitis; it is too soon to speak for certain of this in the present epidemic, but some, at any rate, have made a full recovery.Treatment seems to lhave little influence on the course of, the disease, but, as in poliomyelitis, we should resort to comaplete and absolute rest in the dark, witlh or without the use of bromides or other nerve sedatives, during the stage of onset.Urotropin lhas been given, from a belief in its antiseptic effect ou the central nervous system, and salol for a similar action on the nasopharynx, by which route infection is supposed to reach the brain.Lumbar puncture should be performed and, if necessary, repeated in cases which show the more marked signs of intracranial pressure, suclh as severe pain in the head, vomiting, and unconsciousness.Later, tonic treatment, such as iron, arsenic, strychnine, and cod-liver oil, with fresh air, are likeliest to restore the vitality of the damaged nerve centres.
The Manual for the Staging of Cancer
Authors: DAVID T. CARR
Journal: Annals of Internal Medicine (1977)

Editorial Notes1 October 1977The Manual for the Staging of CancerDAVID T. CARR, M.D., F.A.C.P.DAVID T. CARR, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-87-4-491 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptGertrude Stein may have said "a rose is a rose is a rose," but she never would have said "a cancer is a cancer is a cancer." Neither would anyone else who gave the complicated problem of cancer more than a passing thought. The complexity of the collection of more than one hundred separate diseases called cancer has made necessary the development of numerous systems of classification. These have been based on such characteristics as the organ or tissue of origin; the histologic cell type of the cancer; the grade of differentiation of the malignancy; its growth rate; the presence... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Oncology Mayo Medical School Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPrognostic significance of extent of venous tumor thrombus in patients with non-metastatic renal cell carcinoma: Results from a Canadian multi-institutional collaborativeMargins of Melanoma Excision and Modifications to StandardsA proposal of post-operative nomogram for overall survival in patients with renal cell carcinoma and venous tumor thrombusPrognostic role of urinary collecting system invasion in renal cell carcinoma: a systematic review and meta-analysisInvasion of the urinary collecting system is an independent prognostic factor in pT3 renal cell carcinomaUrinary Collecting System Invasion Is a Predictor for Overall and Disease-specific Survival in Locally Invasive Renal Cell CarcinomaClinicopathological Assessment of Locally Recurrent Rectal Cancer and Relation to Local Re-Recurrence 1 October 1977Volume 87, Issue 4Page: 491-492KeywordsCell differentiation ePublished: 1 December 2008 Issue Published: 1 October 1977 PDF downloadLoading ...
INFECTIONS IN DIABETES
Authors: Frank Hellier
Journal: British Journal of Dermatology (1975)

Journal Article INFECTIONS IN DIABETES Get access Frank Hellier Frank Hellier 20 Clarendon Road, Leeds LS2 9PF Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 92, Issue 4, 1 April 1975, Page 480, https://doi.org/10.1111/j.1365-2133.1975.tb03113.x Published: 01 April 1975
Alcohol and Hemorrhagic Stroke
Authors: Richard P. Donahue
Journal: JAMA (1986)

Since 1965, the Honolulu Heart Program has followed up 8,006 men in a prospective study of cardiovascular disease. Of those subjects free of stroke at the time of study entry, 2,916 were classified as nondrinkers of alcohol and 4,962 as drinkers. In 12 years of follow-up, 197 drinkers and 93 nondrinkers experienced a stroke. No significant relationships were noted between alcohol and thromboembolic stroke. When compared with nondrinkers, however, the risk of hemorrhagic stroke more than doubled for light drinkers and nearly tripled for those considered to be heavy drinkers. These findings are statistically significant and independent of hypertensive status and other risk factors. Results further indicate that alcohol has a greater effect on hemorrhagic strokes that are subarachnoid in origin, conferring a threefold to fourfold increased risk for moderate and heavy drinkers compared with nondrinkers.
Bleeding in Uremia — A Clinical Challenge
Authors: Angelina C. A. Carvalho
Journal: New England Journal of Medicine (1983)

IN this issue of the Journal, Mannucci et al. report that infusions of a synthetic derivative of antidiuretic hormone — l-deamino-8-D-arginine vasopressin (DDAVP) — shorten the prolonged bleeding time and prevent bleeding complications in patients with uremia who undergo surgical procedures.1 Administration of DDAVP resulted in a consistent post-infusion increase in all coagulant activities associated with the factor VIII molecule, as well as the appearance in the circulation of larger factor VIII:von Willebrand factor (FVIII:VWF) multimers than had been present in the resting state. The maximal shortening of the bleeding time coincided with the appearance in the plasma of . . .
Liver-Cell Adenomas Associated with Use of Oral Contraceptives
Authors: Hugh A. Edmondson, Brian Henderson, Barbara Benton
Journal: New England Journal of Medicine (1976)

During the past six years an increasing number of liver-cell adenomas in women were diagnosed, and we undertook a study of possible etiologic faciors, including use of oral contraceptives, in 42 women. There was a significant difference between cases and matched controls in mean months of oral-contraceptive use: 73.4 as compared to 36.2 (P<0.001). The women with adenomas look mestranol-containing pills much more commonly than the controls (P<0.0001). Hemorrhage into the tumor was often associated with the onset of menstruation in women taking oral contraceptives. Long-term use of oral contraceptives, especially those containing a high total dose of steroids or mestranol as the synthetic estrogen, should be balanced against risks of side effects of the drugs. (N Engl J Med 294:470–472, 1976)
Outbreak of Fatal Childhood Lead Poisoning Related to Artisanal Gold Mining in Northwestern Nigeria, 2010
Authors: Carrie A. Dooyema, Antonio Neri, Yi-Chun Lo, James Durant, Paul I. Dargan, Todd Swarthout, Oladayo Biya, Saheed O. Gidado, Suleiman Haladu, Nasir Sani-Gwarzo, Patrick M. Nguku, Henry Akpan, Sa’ad Idris, Abdullahi M. Bashir, Mary Jean Brown
Journal: Environmental Health Perspectives (2011)

In May 2010, a team of national and international organizations was assembled to investigate children's deaths due to lead poisoning in villages in northwestern Nigeria.Our goal was to determine the cause of the childhood lead poisoning outbreak, investigate risk factors for child mortality, and identify children < 5 years of age in need of emergency chelation therapy for lead poisoning.We administered a cross-sectional, door-to-door questionnaire in two affected villages, collected blood from children 2-59 months of age, and obtained soil samples from family compounds. Descriptive and bivariate analyses were performed with survey, blood lead, and environmental data. Multivariate logistic regression techniques were used to determine risk factors for childhood mortality.We surveyed 119 family compounds. Of 463 children < 5 years of age, 118 (25%) had died in the previous year. We tested 59% (204/345) of children < 5 years of age, and all were lead poisoned (≥ 10 µg/dL); 97% (198/204) of children had blood lead levels (BLLs) ≥ 45 µg/dL, the threshold for initiating chelation therapy. Gold ore was processed inside two-thirds of the family compounds surveyed. In multivariate modeling, significant risk factors for death in the previous year from suspected lead poisoning included the age of the child, the mother's work at ore-processing activities, community well as primary water source, and the soil lead concentration in the compound.The high levels of environmental contamination, percentage of children < 5 years of age with elevated BLLs (97%, > 45 µg/dL), and incidence of convulsions among children before death (82%) suggest that most of the recent childhood deaths in the two surveyed villages were caused by acute lead poisoning from gold ore-processing activities. Control measures included environmental remediation, chelation therapy, public health education, and control of mining activities.
THE SO-CALLED MUCOUS COLITIS OR SPASTIC IRRITABLE COLON
Authors: CHARLES W. McGAVRAN
Journal: JAMA (1942)

This is not a disease, it is a condition. It is due to a disturbance in  vegetative or autonomic nervous system. Usually it is neurogenic in origin, although often it is  result of irritation either in  gastrointestinal tract or in  organs adjacent to  gastrointestinal tract. While not critically ill, these patients, because of their anxiety, are really sick. The mortality is nil but  morbidity is great. Because  pain of a spastic irritable  can simulate  pain associated with disease of any organ of  abdomen,  patient should not be subjected to surgical or even stringent medical therapy without  benefit of adequate study. The story  clinician so frequently hears when he is consulted by a patient suffering from the so-called mucous colitis or spastic irritable colon is illustrated by  following case history:  A married woman of 46 complains of
Breaking the Bonds: Non-viral Vectors Become Chemically Dynamic
Authors: Jon A Wolff, David B Rozema
Journal: Molecular Therapy (2007)

The delivery of a variety of nucleic acids such as plasmid DNA (pDNA) and small interfering RNA (siRNA) to mammalian cells is both an important research tool and potential therapeutic approach. Synthetic vehicles (SVs) that include lipoplexes and polyplexes, are widely used for non-viral delivery. A promising method of improving the efficacy of this approach is to create SVs that are chemically dynamic, so that delivery is enabled by the cleavage of chemical bonds upon exposure to various physiological environments or external stimuli. An example of this approach is the use of masked endosomolytic agents (MEAs) that improve the release of nucleic acids from endosomes, a key step during transport. When the MEA enters the acidic environment of the endosome, a pH-labile bond is broken, releasing the agent';s endosomolytic capability. Another challenge has been to develop SVs that enable in vivo delivery. Recently, an MEA that was used within dynamic polyconjugates (DPCs) enabled the efficient delivery of siRNA into hepatocytes in vivo. The use of labile bonds to mask endosomolytic agents, provides a critical design feature, because it enables efficient in vivo delivery without sacrificing endosomolytic function for release into the cytoplasm.
Tumor suppressor p16 methylation in multiple myeloma: biological and clinical implications
Authors: Natalia Gonzalez-Paz, Wee J. Chng, Rebecca F. McClure, Emily Blood, Martin M. Oken, Brian Van Ness, C. David James, Paul J. Kurtin, Kimberly Henderson, Gregory J. Ahmann, Morie Gertz, Martha Lacy, Angela Dispenzieri, Philip R. Greipp, Rafael Fonseca
Journal: Blood (2006)
Effects of inotropic interventions on end systolic length-force curve of cat ventricular muscle
Authors: B. R JEWELL, D. A HANCK
Journal: Cardiovascular Research (1987)

Journal Article Effects of inotropic interventions on end systolic length-force curve of cat ventricular muscle Get access BRIAN R JEWELL, BRIAN R JEWELL From the Department of Physiology, University of Leeds, Leeds Search for other works by this author on: Oxford Academic PubMed Google Scholar DOROTHY A HANCK DOROTHY A HANCK * From the Department of Physiology, University of Leeds, Leeds *Present address: Departments of Medicine and Physiological and Pharmacological Sciences. Hospital Box 249, 950 East 59th Street, Chicago, Illinois 60637, USA. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 21, Issue 8, August 1987, Pages 559–564, https://doi.org/10.1093/cvr/21.8.559 Published: 01 August 1987 Article history Received: 29 October 1986 Accepted: 17 January 1987 Published: 01 August 1987
Improvement in Quality of Life Measurements in Newly Diagnosed Patients with Primary Immunodeficiency Receiving Directly Initiated Subcutaneous Replacement Therapy with Vivaglobin
Authors: M. Borte, B. Ritchie, A. Plebani, C. McCusker, E. Fernández-Cruz, D.S. Schmidt, I. Andresen, I. Quinti
Journal: Journal of Allergy and Clinical Immunology (2010)
Regulation of osteoclast differentiation and function by the CaMK-CREB pathway
Authors: Kojiro Sato, Ayako Suematsu, Tomoki Nakashima, Sayaka Takemoto-Kimura, Kazuhiro Aoki, Yasuyuki Morishita, Hiroshi Asahara, Keiichi Ohya, Akira Yamaguchi, Toshiyuki Takai, Tatsuhiko Kodama, Talal A Chatila, Haruhiko Bito, Hiroshi Takayanagi
Journal: Nature Medicine (2006)