tbuckley/cabot-search huggingface dataset:
Knowledge tool introduced for the NHS
Authors: Tessa Richards
Journal: BMJ (2007)

From mid-July all health professionals working in the NHS will have free access to the Map of Medicine (www.mapofmedicine.com), an online knowledge resource aimed at facilitating good clinical practice.

The map gives visual pathways through the assessment, investigation, and primary and secondary care management of some 370 common symptoms and conditions.

The map was pioneered by clinicians in two London teaching hospitals and is already available in Wales and most regions in the north and south of England. The software is owned by Informa, a UK company whose core business is scientific publishing, and its national roll …
The Electromagnetic Interference of Mobile Phones on the Function of a γ-Camera
Authors: Hamid Javadi, Zahra Azizmohammadi, Ali Mahmoud Pashazadeh, Isa Neshandar Asli, Taleb Moazzeni, Nastaran Baharfar, Babak Shafiei, Iraj Nabipour, Majid Assadi
Journal: Clinical Nuclear Medicine (2014)

The aim of the present study is to evaluate whether or not the electromagnetic field generated by mobile phones interferes with the function of a SPECT γ-camera during data acquisition.We tested the effects of 7 models of mobile phones on 1 SPECT γ-camera. The mobile phones were tested when making a call, in ringing mode, and in standby mode. The γ-camera function was assessed during data acquisition from a planar source and a point source of Tc with activities of 10 mCi and 3 mCi, respectively. A significant visual decrease in count number was considered to be electromagnetic interference (EMI).The percentage of induced EMI with the γ-camera per mobile phone was in the range of 0% to 100%. The incidence of EMI was mainly observed in the first seconds of ringing and then mitigated in the following frames.Mobile phones are portable sources of electromagnetic radiation, and there is interference potential with the function of SPECT γ-cameras leading to adverse effects on the quality of the acquired images.
Preferential amplification of the paternal allele of the N–myc gene in human neuroblastomas
Authors: Judy M. Cheng, Jill L. Hiemstra, Sandra S. Schneider, Anna Naumova, Nai-Kong V. Cheung, Susan L. Cohn, Lisa Diller, Carmen Sapienza, Garrett M. Brodeur
Journal: Nature Genetics (1993)
Acute Pulmonary Edema of Altitude
Authors: HERBERT L. FRED, ALEXANDER M. SCHMIDT, TALCOTT BATES, HANS H. HECHT
Journal: Circulation (1962)

Three separate episodes of acute pulmonary edema are described that developed in two otherwise healthy individuals during heavy exertion at high altitudes. Detailed physical examination and laboratory studies failed to demonstrate pulmonary infection or cardiac disease. Data obtained by cardiac catheterization during one of these episodes revealed elevation of the pulmonary artery pressure and a normal left atrial pressure. This syndrome appears to be the consequence of pulmonary vascular obstruction distal to the capillary bed, presumably in the pulmonary veins. It is brought about by exposure of susceptible individuals to high altitudes, and is completely reversed by oxygen administration.
Treatment of Tapeworm Infections in Man
Authors: W. H. Jopling, A. W. Woodruff
Journal: BMJ (1959)

Remarkably little information is available on the efficacy of different anthelmnintic regimes under standard conditions; assessment of their relative merits is therefore difficult or impossible.In an effort to supply this need, detailed observations have been made on all patients treated for tapeworm infections at the Hospital for Tropical Diseases, London, during the past eight years.
"A NEW SIGN OF PERICARDIAL EFFUSION"
Authors: Eli Moschcowitz
Journal: JAMA (1933)

<h3>To the Editor:</h3> —I am not surprised that the sign of pericardial effusion, which I described, had been previously observed, because it is apparently so obvious; but I confess that the references mentioned had escaped me. My readings, I admit, were largely devoted to the most modern of textbooks on physical diagnosis and on diseases of the heart. These, singularly enough, are silent with respect to the sign. At all events, it is apparently not widely known, as evidenced by the fact that it appeared novel to every one to whom I had demonstrated the sign for the past few years in various hospital wards. I am deeply grateful for having my attention called to these references.
Actin filament formation, reorganization and migration are impaired in hepatic stellate cells under influence of trichostatin A, a histone deacetylase inhibitor
Authors: Krista Rombouts, Thomas Knittel, Laura Machesky, Filip Braet, Annemie Wielant, Karine Hellemans, Pieter De Bleser, Irwin Gelman, Giuliano Ramadori, Albert Geerts
Journal: Journal of Hepatology (2002)
when do we say “no”?
Authors: Thomas R Aust
Journal: BMJ (2004)

Tommy's doctors made the right decision to support her in trying for a natural pregnancy by optimising her diabetic treatment and advising her of the risks of becoming pregnant.1 This is because many patients will carry on and conceive with or without their doctors' blessing. After all, we would prefer it if drug misusers didn't inject heroin, but if they must we would rather they use clean needles.

Tommy's request for assisted conception was a different matter because all complications of assisted conception are, by definition, iatrogenic. Her doctors …
Sudden Cardiac Death
Authors: William H. Wehrmacher
Journal: JAMA (1965)

Thirty-three outstanding authorities reviewed the mechanisms responsible for sudden (nonviolent) death and presented new information from the electro-physiological, anatomic, and clinical standpoints.  The overwhelming majority of patients who die suddenly have diffuse coronary artery disease. Angiography demonstrates it with clarity during life. At the University Hospitals, Cleveland, terminal electrocardiograms recording the precise moment the heart stopped beating effectively were available from 113 patients. This study demonstrated two mechanisms of death. Primary power  characterized by myocardial failure, hypotension, and shock, was responsible for death in 42%; electrical  characterized by disturbances of the cardiac mechanism and arrhythmias, was responsible in 40%. A combination of both was responsible in 18%.  According to Pick, antiarrhythmic drugs, such as quinidine, help ventricular fibrillation incident to premature beats. Scherf maintains that quinidine is indicated in all patients with myocardial infarction who have ectopic rhythms, with two exceptions... heart block... and.
A returning traveller with fever, facial swelling, and skin lesions
Authors: J. Richter, S. Gobels, T. Gobel, R. Westenfeld, I. Muller-Stover, D. Haussinger
Journal: BMJ (2012)

A 58 year old man presented to the emergency department with fevers and lethargy. He had recently been in Zambia for 15 days, where he had spent time in Lusaka and at a game reserve. Three days earlier, while still in Lusaka, he had noted painful swellings on his right leg and fever, and although a malaria test was negative the fevers continued, so he returned home to Germany early. At presentation, he was drowsy and his speech was slurred, so the history was obtained from his sister. He had not taken antimalarials during his trip, but he had been vaccinated against tetanus, diphtheria, and rabies before travel. 

On examination his temperature was 39.4°C, respiration 18 breaths/min, pulse 96 beats/min, and blood pressure 95/80 mm Hg. His Glasgow coma score was 12/15, and facial swelling was noted around his eyes and cheeks. Apart from moderate hepatosplenomegaly and a systolic mitral valve click owing to a St Jude prosthesis implanted five years earlier, his physical examination was normal. There was no focal neurological abnormality or evidence of meningism. A generalised macular exanthema was noted on his trunk, along with two indurated skin lesions about 6 cm in diameter on his right leg (fig 1⇓).



Blood tests showed haemoglobin 126 g/L (normal range 140-180), leucocytes 5.6×109 cells/L (4-11; lymphocytes 0.02 (0.25-0.4.), neutrophils 0.84 (0.50-0.75)), platelets 40×109 cells/L (150-400), C reactive protein 1807 μmol/L (8-31), creatine kinase 364 U/L (<171), total bilirubin 51.85 μmol/L (<17.0), aspartate aminotransferase 163 U/L (<35), alanine aminotransferase 205 U/L (<45), γ-glutamyltransferase 274 (<55) U/L, serum creatinine 477.36 μmol/L (<97). Serum electrolytes were within the normal range. Urine dipstick was positive for protein, erythrocytes, and leucocytes as well as some hyaline casts. Blood films were negative for malaria but showed unusual extracellular structures (fig 2 …
The Use of Race in Medical Research
Authors: Manning Feinleib
Journal: JAMA (1992)

To the Editor.  —The Commentary entitled  Use of Race in Medical Research by Drs Osborne and Feit 1 is an articulate response to a question asked with some frequency in medical research today: Is race a valid characteristic by which to describe health status and health outcome? The authors' response is no. They conclude that race is highly correlated with social, economic, and political factors and therefore has no separate value in medical research. However, it is just that relationship of race to economic and social factors in our society that makes race a meaningful variable by which to describe and analyze health outcomes.  Countless studies show significant racial and ethnic disparities in every aspect of health from infant mortality, to chronic disease prevalence and disability, to life-styles and health habits, to access to quality health care. 2 Race is a powerful correlate of health outcomes and points to
ISOLATION OF ß1F-GLOBULIN FROM HUMAN SERUM AND ITS CHARACTERIZATION AS THE FIFTH COMPONENT OF COMPLEMENT
Authors: Ulf R. Nilsson, Hans J. Müller-Eberhard
Journal: The Journal of Experimental Medicine (1965)

At least 3 complement factors were found necessary for the conversion of the thermolabile intermediate complex EAC'1a,4,2a to a thermostable state. One of these factors is the earlier described beta(1C)-globulin. The second, a heretofore unrecorded serum protein, beta(1F)-globulin. The third factor has not yet been defined as a discrete serum protein entity. Kinetic experiments indicated that beta(1C) reacted prior to beta(1F), which in turn seemed to precede the third factor in the reaction sequence. Therefore, the 3 components were tentatively designated the third (C'3), the fifth (C'5), and the sixth (C'6) components of complement, respectively. A procedure was developed allowing the isolation of highly purified beta(1C)-(C'3) and beta(1F)-globulin (C'5) and of partially purified C'6. With respect to its function in immune hemolysis, beta(1F)-globulin or C'5 was found to be closely dependent on the simultaneous presence of C'6. The hypothesis that C'5 and C'6 form a functional unit was supported by the finding that both components interact with each other in solution resulting in the formation of a complex. A similar complex was also found in fresh human serum.
Hepatic Homing of Labelled Lymphocytes in Man
Authors: J. Chanard, J.-F. Bach, J. Assailly, J.-L. Funck-Brentano
Journal: BMJ (1972)

The homing of human lymphocytes has been studied in man by means of chromium labelling and external organ counting. The method was applied to the study of lymphocyte alteration induced by antilymphocyte globulin (A.L.G.). At non-cytotoxic concentrations A.L.G. has an opsonizing effect on lymphocytes, increasing selectively their homing to the liver. No correlation could be defined between in-vitro cytotoxicity or rosette-inhibiting activity and hepatic fixation. These results suggest that A.L.G. may act by promoting lymphocyte trapping by the reticuloendothelial cells.
Patients' unvoiced agendas in general practice consultations: qualitative study
Authors: C. A Barry
Journal: BMJ (2000)

Objective: To investigate patients' agendas before consultation and to assess which aspects of agendas are voiced in the consultation and the effects of unvoiced agendas on outcomes. Design: Qualitative study. Setting: 20 general practices in south east England and the West Midlands. Participants: 35 patients consulting 20 general practitioners in appointment and emergency surgeries. Results: Patients' agendas are complex and multifarious. Only four of 35 patients voiced all their agendas in consultation. Agenda items most commonly voiced were symptoms and requests for diagnoses and prescriptions. The most common unvoiced agenda items were: worries about possible diagnosis and what the future holds; patients' ideas about what is wrong; side effects; not wanting a prescription; and information relating to social context. Agenda items that were not raised in the consultation often led to specific problem outcomes (for example, major misunderstandings), unwanted prescriptions, non-use of prescriptions, and non-adherence to treatment. In all of the 14 consultations with problem outcomes at least one of the problems was related to an unvoiced agenda item. Conclusion: Patients have many needs and when these are not voiced they can not be addressed. Some of the poor outcomes in the case studies were related to unvoiced agenda items. This suggests that when patients and their needs are more fully articulated in the consultation better health care may be effected. Steps should be taken in both daily clinical practice and research to encourage the voicing of patients' agendas
Frequency of Cholinergic and Caudate Nucleus Dopaminergic Deficits Across the Predemented Cognitive Spectrum of Parkinson Disease and Evidence of Interaction Effects
Authors: Nicolaas I. Bohnen, Roger L. Albin, Martijn L. T. M. Müller, Myria Petrou, Vikas Kotagal, Robert A. Koeppe, Peter J. H. Scott, Kirk A. Frey
Journal: JAMA Neurology (2014)

Little is known about the relative contributions of multisystem degenerative processes across the spectrum of predemented cognitive decline in Parkinson disease (PD).To investigate the relative frequency of caudate nucleus dopaminergic and forebrain cholinergic deficits across a spectrum of cognitively impaired patients with PD to explore their relative, individual, and combined contributions to cognitive impairment in PD.A cross-sectional study at an academic movement disorders clinic that included a predominantly nondemented cohort of 143 patients with PD. The mean (SD) age of patients was 65.5 (7.4) years and the mean (SD) Hoehn and Yahr stage was 2.4 (0.6).Binary classification of carbon 11-labeled [11C]PMP acetylcholinesterase and caudate nucleus [11C]DTBZ monoaminergic positron-emission tomography imaging based on normative data. The frequency of significant degenerative processes based on normative values was determined for consecutive intervals of cognitive impairment, ranging from no or minimal (z > -0.5) to more severe (z ≤ -2) cognitive impairment.Across the spectrum from minimal (z > -0.5) to more severe (z ≤ -2) global cognitive impairment scores, caudate nucleus dopaminergic denervation was relatively frequent in individuals with minimal or no cognitive changes (51.1%) and increased in patients with more severe cognitive impairments (χ2 = 12.8; P = .01). Cortical cholinergic denervation frequency increased monotonically with increasing cognitive impairment from 24.7% (z > -0.5) to 85.7% (z ≤ -2); χ2 = 23.2; P = .001). Eighty-seven percent of patients with neocortical cholinergic deficits had caudate nucleus dopaminergic deficits. Multiple regression analysis (F = 7.51; P < .001) showed both independent cognitive predictions for caudate nucleus dopaminergic (F = 7.25; P = .008) and cortical cholinergic (F = 7.50; P = .007) degenerations as well as interaction effects (F = 5.40; P = .02).Cortical cholinergic denervation is a major neurodegeneration associated with progressive declines across the spectrum of cognitive impairment in PD and typically occurs in the context of significant caudate nucleus dopaminergic denervation. Our findings imply that dopaminergic and cholinergic degenerations exhibit both independent and interactive contributions to cognitive impairment in PD.
Comparative Safety of Vascular Closure Devices
Authors: Hitinder S. Gurm, Carrie Hosman, Ben B. Hansen
Journal: Annals of Internal Medicine (2014)

Letters18 March 2014Comparative Safety of Vascular Closure DevicesHitinder S. Gurm, MD, Carrie Hosman, PhD, and Ben B. Hansen, PhDHitinder S. Gurm, MDFrom University of Michigan, Ann Arbor, Michigan.Search for more papers by this author, Carrie Hosman, PhDFrom University of Michigan, Ann Arbor, Michigan.Search for more papers by this author, and Ben B. Hansen, PhDFrom University of Michigan, Ann Arbor, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5006-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Drs. Shah and Khan that observational data alone can establish association but not causation. Because of the possibility of unmeasured confounding, such associations at best suggest a causal link. Although we take this to be widely understood, we nonetheless reaffirmed it in the abstract and body of our article. More important, we adjusted for a broad array of potential confounders, including several of those mentioned by Drs. Shah and Khan; analyzed the sensitivity of the adjusted association to hypothetical further adjustments for additional confounders; and presented results from an empirical evaluation of the completeness of ...References1. LeLorier J, Grégoire G, Benhaddad A, Lapierre J, Derderian F. Discrepancies between meta-analyses and subsequent large randomized, controlled trials. N Engl J Med. 1997;337:536-42. [PMID: 9262498] CrossrefMedlineGoogle Scholar2. Biancari F, D'Andrea V, Di Marco C, Savino G, Tiozzo V, Catania A. Meta-analysis of randomized trials on the efficacy of vascular closure devices after diagnostic angiography and angioplasty. Am Heart J. 2010;159:518-31. [PMID: 20362708] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Michigan, Ann Arbor, Michigan.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0899. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Safety of Vascular Closure Devices and Manual Closure Among Patients Having Percutaneous Coronary Intervention Hitinder S. Gurm , Carrie Hosman , David Share , Mauro Moscucci , Ben B. Hansen , and Comparative Safety of Vascular Closure Devices Rahman Shah and M. Rehan Khan Comparative Safety of Vascular Closure Devices Rahman Shah and M. Rehan Khan Metrics 18 March 2014Volume 160, Issue 6Page: 438-439KeywordsClinical trialsConflicts of interestDisclosureMotivationObservational studiesPercutaneous coronary interventionSafety ePublished: 18 March 2014 Issue Published: 18 March 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Clinical and In Vitro Evaluation of Cephalexin
Authors: Matthew E. Levison
Journal: JAMA (1969)

Cephalexin was evaluated in vitro and in the treatment of urinary tract infection. The drug was absorbed well and excreted in the urine in high concentrations. Urine levels of cephalexin were adequate to inhibit more than 90% of Escherichia coli, Proteus mirabilis , and Klebsiella pneumoniae strains. Twenty-three patients with urinary tract infection were treated with cephalexin for two to three weeks. Most of the patients had evidence of structural abnormalities or chronic infection of the urinary tract. Ten patients (43%) were abacteriuric two or more months after discontinuation of therapy. Diarrhea and eosinophilia were the only side effects noted and occurred in only two patients.
Higher susceptibility to apoptosis following ultraviolet B irradiation of xeroderma pigmentosum fibroblasts is accompanied by upregulation of p53 and downregulation of Bcl-2
Authors: None Washio, None Ueda, None Ito, None Ichihashi
Journal: British Journal of Dermatology (1999)

Apoptosis plays an important part as a defence mechanism in eliminating damaged cells. Among the complex factors which regulate apoptosis, the p53 tumour suppressor protein which is induced by DNA damage has been suggested to play a crucial part. Cells from xeroderma pigmentosum (XP) patients, which are defective in nucleotide excision repair, express higher levels of p53 and are highly susceptible to cell death after ultraviolet (UV) irradiation. To examine the relationships between DNA damage, p53 and apoptosis, normal and XP group A fibroblasts were exposed to UVB, and expressions of molecules involved in apoptosis were examined. Apoptosis of XP and normal cells was clearly detected at 48 h after irradiation with UVB at doses of 5 and 40 mJ/cm2, respectively. Cells were positive by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling (TUNEL) staining under these exposure conditions. At 6 h after irradiation, p53 protein expression was induced in normal and XP cells at minimal doses of 10 and 2.5 mJ/cm2, respectively. Bcl-2 protein, an inhibitor of apoptosis, was downregulated prior to cell death following UVB exposure at doses that induced apoptosis in both cell types. These results suggest that DNA damage due to UVB induces apoptosis by upregulating proapoptotic molecules such as p53, and by downregulating anti-apoptotic molecules such as Bcl-2.
Women's autonomy in childbirth
Authors: S. Goldbeck-Wood
Journal: BMJ (1997)

The lay and medical press have recently hosted a vigorous debate over enforced caesarean sections. At least six cases have been reported in the past six months, of which one, albeit an unusual one, is discussed in this week's BMJ (p 1183).1 A landmark judgment from the court of appeal this March has clarified the legal position: a mentally competent patient has an absolute right to refuse medical treatment even where that decision might lead to her death or the death of her baby, for any rational or irrational reason or for no reason at all. What this means is that unless capacity to consent is at issue, the courts are unlikely to consider future applications of this kind. The capacity to consent is assumed to be present until it is shown not to be, and is quite distinct from mental health or rationality.2 This still leaves some obstetricians feeling uncomfortable.

In this week's BMJ four sets of commentators …
Herpes Simplex Cervicitis
Authors: Goryun Nigogosyan
Journal: JAMA (1965)

HERPETIC INFECTIONS of the penis, 1,2 vagina, and vulva 3 -5 are well known and well documented. Their venereal origin was suspected by Unna in 1883, who emphasized their frequent occurrence among prostitutes. 6 However, no modern textbook of gynecology or cervical pathology mentions herpetic cervicitis, and we consider the following report worthwhile.  Report of a Case  The patient, a 20-year-old unmarried white female, was seen on March 18, 1964, complaining of a foul vaginal discharge of about two weeks' duration. Her last menstrual period was on Feb 26. The vulva and vagina were intact but there was a large amount of dark-brown purulent material in the vagina. The cervix appeared dark gray to black, edematous, and friable. Punch biopsies were taken from the outer portion of the cervix, causing considerable bleeding which stopped spontaneously.  The microscopical examination revealed small pieces of cervical tissue covered by squamous epithelium and masses