tbuckley/cabot-search huggingface dataset:
Rehabilitation of patients with cardiac conditions.
Authors: D Gloag
Journal: BMJ (1985)

Poor school progress may be due to lingustic difficulties at school entry and may be an acute problem in an older child who has recently come to Britain.In families who run restaurants the children may be expected to help behind the scenes instead of doing their homework.Transcultural problems-Older children, particularly teenagers, often have difficulty in reconciling the patterns of behaviour which they learn at school with those required of them at home.Asian girls may be expected to stay at home in the evenings and not to go out to discos.The prospect of an arranged marriage can be deeply dis- turbing to a girl brought up in the United Kingdom.Children who can be instantly categorised as being "non-European" because of skin colour or facial appearance may have great difficulty in establishing their true identity and gaining acceptance in the community as a whole.
The Intraepithelial Lesion: A Spectrum of Problems
Authors: D. K. Ohrt
Journal: JAMA (1989)

The Bethesda System described in this week's issue ofThe Journalis an improved approach to reporting cervical/vaginal cellular abnormalities.<sup>1</sup>When abnormal, the "routine Pap smear" initiates a complex chain of events, judgments, and interactions. From a quality assurance perspective, it is necessary that each link be carefully performed if the clinical episode as a whole is to have any utility. The attending physician, cytopathologist, and the patient herself all have roles that will make or break this concatenation.<sup>2</sup> Backed by their office managers, attending physicians have too often sought the low-price competitor with the best turnaround time. Ironically, as the price of reading and interpreting cervical cytology samples has been leveraged downward by competition for contracts, the price to the patient or payer has been pushed upward. Some physicians have become much like brokers, all too often failing to concern themselves with the necessary balance of cost
Cause-specific mortality and the extended effects of particulate pollution and temperature exposure.
Authors: Patrick G Goodman, Douglas W Dockery, Luke Clancy
Journal: Environmental Health Perspectives (2003)

Air pollution exposure studies in the past decade have focused on acute (days) or long-term (years) effects. We present an analysis of medium-term (weeks to months) exposure effects of particulate pollution and temperature. We assessed the associations of particulate pollution (black smoke) and temperature with age-standardized daily mortality rates over 17 years in Dublin, Ireland, using a polynomial distributed lag model of both temperature and particulate air pollution simultaneously through 40 days after exposure. When only acute effects (3-day mean) were considered, we found total mortality increased by 0.4% for each 10-microg/m3 increase in black smoke concentration. When deaths in the 40 days after exposure were considered, we found a 1.1% increase. For respiratory mortality, the estimated effect was 0.9% for acute exposures, but 3.6% for the extended follow-up. We found each increase in current-day temperature by 1 degree C was associated with a 0.4% increase in total mortality, whereas each decrease of 1 degree C was associated with a 2.6% increase in mortality in the following 40 days. For both temperature and pollution, the largest effects on cardiovascular mortality were observed immediately, whereas respiratory mortality was delayed and distributed over several weeks. These effects were two to three times greater than the acute effects reported in other studies, and approach the effects reported in longer-term survival studies. This analysis suggests that studies on the acute effects of air pollution have underestimated the total effects of temperature and particulate air pollution on mortality.
Waiting in the NHS
Authors: A C Flind
Journal: Journal of the Royal Society of Medicine (2002)

Professor Hamblin (July 2002 JRSM1), writing from the Royal Bournemouth Hospital, lists a number of favourable circumstances that helped Dorset achieve a sustained reduction in waiting times. Improvements in the statistics of waiting lists and waiting times are important politically, and one hopes they will be echoed by the experience of patients.

I have an elderly relative living on her own in Christchurch, Dorset. Towards the end of March this year her GP told her he would refer her for a medical outpatient appointment. In the second week of May she received a letter from the hospital saying that the specialist ‘... has seen your doctor's letter and asked us to place you on the outpatient waiting list. We will write to you four weeks before your appointment is due advising you of the date, time [etc.]’. In the second week of July she received a further letter, stating: ‘... we are now in a position to arrange your appointment. Would you please telephone us at the earliest opportunity to make your Outpatient Appointment.’ She telephoned and received an appointment for mid-August.

Does the waiting time start from the referral letter, from the time the consultant had asked to have her placed on the outpatient waiting list, or from the allocation of an appointment? Four and a half months, three months or one month? Her most anxious time was during the first few weeks before she received any response from the hospital at all.

During her waiting time, she spent sixteen days as an inpatient in the same hospital for another matter, during which time she asked whether the medical referral might be dealt with while she was there. This did not happen.
BLOOD PRESSURE OBSERVATIONS IN FUNCTIONAL BRUITS IN CHILDREN AND YOUNG ADULTS
Authors: A. F. Martin
Journal: BMJ (1922)

V-aryina coniditions of climate.diet-of hlygiene generallyofteln affect in a degree so marked as to be obvicus the grosser results of differing functionl of these organs andl systerms-for exam-ple, goitre, atlhma.We cannot deny the possibility of a. diffeience according to locality in tile degree of frequLency of xcrCIetio in the ulriniC of a reducing substance in detectable clin1ical amnounts.This leads to tic thiird considleration: IShould suchi mninor test results as thlose I am' discussing be co-nsidered nealigible anid physiological or not?I thlilink they shiould always be noted, loNever slighit and however fleeting they be, and ani explanation souigait.It is possible tlhat most, if not all, cllildren from timn to time may give detectable sugar reac- tion on examiination of the uirine, but even so this formus no foundation for an arguient that the detection of suchi a reaction is of negligible significance.If once foutnd, examination of nilnmerious specimens shiould be inac1e-of thic twenty-fourhlours' urine and also of miiorniilg and eveuiig specimilens.In a large proportion of cases the presence of a positive test corresponds witil indiscretion in dliet or digestive disturbance, aud disappears on -coriection of suchl.In other children witl indiaestion and constipatioi' the reaction is completely negative.This point is in itself important, as possibly affording evidence of inidividual idliosyncrasy in carboliydrate metabolisnii.Aniother important line of consideration is demuonstrated by the findings in' the following case.
Ascorbic acid accelerates left atrial mechanical recovery following a brief duration of atrial fibrillation
Authors: Hirotsugu Yamada, Richard A. Grimm, Neil L. Greenberg, Erwan Donal, Yong-Jin Kim, Deborah A. Agler, Youhua Zhang, Shaowei Zhuang, Kent A. Mowrey, David R. Von Wagoner, Todor N. Mazgalev, James D. Thomas
Journal: Journal of the American College of Cardiology (2003)
Scientists Mine Web Search Data to Identify Epidemics and Adverse Events
Authors: Bridget M. Kuehn
Journal: JAMA (2013)

As individuals increasingly turn to �Dr Google� when a health concern arises, scientists are looking into ways to use the data from these searches to create early warning systems about emerging public health problems�from flu epidemics to drug adverse events.

Already, to help identify emerging influenza epidemics, public health authorities are using Google Flu Trends, which uses an algorithm to estimate the incidence of flu in the United States based on Google searches for certain flu-related words. Search data also might offer more timely warnings about drug interactions or adverse events than traditional surveillance systems, new evidence suggests.
Subungual Squamous Cell Carcinoma
Authors: Fadi F. Attiyeh
Journal: JAMA (1979)

Twelve patients with subungual squamous cell carcinoma were treated at Memorial Sloan-Kettering Cancer Center during a 27-year period. To our knowledge, only 58 cases are reported in the literature. Trauma and chronic infection were predisposing factors in some of the cases, and radiation therapy was a substantive predisposing factor in our series. Disarticulation of the distal phalanx proved effective in most patients. (<i>JAMA</i>241:262-263, 1979)
Evaluation of mitral leaflet motion by echocardiography and jet direction by doppler color flow mapping to determine the mechanism of mitral regurgitation
Authors: William J. Stewart, Philip J. Currie, Ernesto E. Salcedo, Allan L. Klein, Thomas Marwick, Debbie A. Agler, David Homa, Delos M. Cosgrove
Journal: Journal of the American College of Cardiology (1992)
Results of American and European studies of thrombolysis in acute stroke are not conflicting
Authors: A. Bruno
Journal: BMJ (1997)

Editor–The recently published clinical trials of thrombolysis in acute ischaemic stroke have generated much discussion and an unnecessary discrepancy between American and European committees regarding the recommended use of alteplase for acute ischaemic stroke, as Julien Bogousslavsky points out in his editorial on thrombolysis in acute stroke.1

The different results in the American2 and …
Regulation of mesangial cell ion channels by insulin and angiotensin II. Possible role in diabetic glomerular hyperfiltration.
Authors: B N Ling, E E Seal, D C Eaton
Journal: Journal of Clinical Investigation (1993)

We used patch clamp methodology to investigate how glomerular mesangial cells (GMC) depolarize, thus stimulating voltage-dependent Ca2+ channels and GMC contraction. In rat GMC cultures grown in 100 mU/ml insulin, 12% of cell-attached patches contained a Ca(2+)-dependent, 4-picosiemens Cl- channel. Basal NPo (number of channels times open probability) was < 0.1 at resting membrane potential. Acute application of 1-100 nM angiotensin II (AII) or 0.25 microM thapsigargin (to release [Ca2+]i stores) increased NPo. In GMC grown without insulin, Cl- channels were rare (4%) and unresponsive to AII or thapsigargin in cell-attached patches, and less sensitive to [Ca2+]i in excised patches. GMC also contained 27-pS nonselective cation channels (NSCC) stimulated by AII, thapsigargin, or [Ca2+]i, but again only when insulin was present. In GMC grown without insulin, 15 min of insulin exposure increased NPo (insulin > or = 100 microU/ml) and restored AII and [Ca2+]i responsiveness (insulin > or = 1 microU/ml) to both Cl- and NSCC. GMC AII receptor binding studies showed a Bmax (binding sites) of 2.44 +/- 0.58 fmol/mg protein and a Kd (binding dissociation constant) of 3.02 +/- 2.01 nM in the absence of insulin. Bmax increased by 86% and Kd was unchanged after chronic (days) insulin exposure. In contrast, neither Kd nor Bmax was significantly affected by acute (15-min) exposure. Therefore, we concluded that: (a) rat GMC cultures contain Ca(2+)-dependent Cl- and NSCC, both stimulated by AII. (b) Cl- efflux and cation influx, respectively, would promote GMC depolarization, leading to voltage-dependent Ca2+ channel activation and GMC contraction. (c) Responsiveness of Cl- and NSCC to AII is dependent on insulin exposure; AII receptor density increases with chronic, but not acute insulin, and channel sensitivity to [Ca2+]i increases with both acute and chronic insulin. (d) Decreased GMC contractility may contribute to the glomerular hyperfiltration seen in insulinopenic or insulin-resistant diabetic patients.
TARGET LESION THIN-CAP FIBROATHEROMA DETECTED BY VIRTUAL HISTOLOGY INTRAVASCULAR ULTRASOUND AND LONG-TERM PROGNOSIS IN PATIENTS WITH ANGINA PECTORIS
Authors: Hiroyuki Okura, Takahiro Kawamoto, Ryotaro Yamada, Yoshinori Miyamoto, Tetsuo Tsuchiya, Akihiro Hayashida, Yoji Neishi, Tomoichiro Kubo, Nobuya Matsushita, Takeshi Ozaki, Hiroyuki Yamagishi, Iku Toda, Kiyoshi Yoshida
Journal: Journal of the American College of Cardiology (2010)
Porphyria in the royal houses of Stuart, Hanover, and Prussia. A follow-up study of George 3d's illness.
Authors: I. Macalpine, R. Hunter, C. Rimington
Journal: BMJ (1968)

In a previous paper based on the royal physicians' manuscript records it was proposed that George III presented the clinical picture of porphyria.'His illness had traditionally been called manic-depressive psychosis simply because it came in attacks during which he was excited.Essential features were ignored, foremost the physical symptoms by which they were regularly ushered in and accompanied.Nor did the diagnosis account for the fact that he was first deranged in his severest attack at the age of 50 in 1788.2Indeed, in contrast to the popular image, up to his 73rd year all periods of mental incapacity added together hardly amounted to six months. Present StudyIt is the purpose of the present study to establish the diagnosis of porphyria beyond doubt.Since it is hereditary we surveyed the family history for other cases,3 and since it is a metabolic disorder we searched for a living family member in whom abnormal metabolites could be demonstrated in the laboratory.This may be considered " the material evidence" 4 of necessity missing in historical pathography, even equivalent to performing these tests on George III himself, since a coincidental occurrence of so rare a disorder may be dis- counted.Once porphyria has been demonstrated in only onliving member, this historical study falls in line with genetic studies which trace a condition from an established propositus back to former generations.It was not our aim to ascertain the incidence of porphyria in the House of Hanover and its blood connexions.The ramifica-,tions of the family alone would make this an impossible task, and medical records have survived for only a handful.5 More- over, porphyria may be latent and never cause symptoms.Inevitably many blind and inconclusive trails were followed, but, as happens in historical detection, unexpected leads also
How Fibroblasts and Giant Cells Encapsulate Implants: Considerations in Design of Glucose Sensors
Authors: Stephen C Woodward
Journal: Diabetes Care (1982)

Implanted sensors ideally should measure glucose in an extracellular fluid that closely reflects changing concentrations of glucose in plasma; yet fibroblasts, fibrocytes, collagen, and giant cells provide adherent, impermeable, avascular barriers when they encapsulate irregularly-surfaced implants. Thus, sensor design should seek to provide a surface configuration that is without anchoring points for encapsulating cells, a consideration not unlike those posed in developing a nonthrombogenic surface. Examples of well-characterized host responses to various surface configurations are provided to illustrate how surface design features can avoid evoking a barrier of collagen as the host response to the sensor.
Why Trust the Professional?
Authors: F. J. Ingelfinger
Journal: New England Journal of Medicine (1972)

Not all will agree on just how a profession differs from a business, but a major distinctive element is that of trust. In medicine, it is trust that should separate the office visit from the shopping trip; it is the ingredient that should allow the patient to accept medical advice without shaking every item to make sure that the contents match the promise of the label. Yet trust in the medical profession is being attacked by a variety of forces. Some are intentional explosives, hurled by those who, like Bernard Shaw, see the "medical service of the community" as a . . .
Self harm in Goth youth subculture: Conclusion relates only to small sample
Authors: Mark Taubert, Jothy Kandasamy
Journal: BMJ (2006)

<h3>Abstract</h3> Rapid advances in sequencing technologies are producing genomic data on an unprecedented scale. The first, and often one of the most time consuming, step of genomic data analysis is sequence alignment, where sequenced reads must be aligned to a reference genome. Several years of research on alignment algorithms has led to the development of several state-of-the-art sequence aligners that can map tens of thousands of reads per second. In this work, we answer the question “How do sequence aligners utilize modern processors?” We examine four state-of-the-art aligners running on an Intel processor and identify that all aligners leave the processor substantially underutilized. We perform an in-depth microarchitectural analysis to explore the interaction between aligner software and processor hardware. We identify bottlenecks that lead to processor underutilization and discuss the implications of our analysis on next-generation sequence aligner design.
Hypercalcemia in idiopathic myelofibrosis: Modulation of calcium and collagen homeostasis by 1,25‐dihydroxyvitamin D3
Authors: A. Voss, K. Schmidt, H. Hasselbalch, P. Junker
Journal: American Journal of Hematology (1992)

Abstract A case of idiopathic myelofibrosis (IMF) presenting with hypercalcemia and hypercalcitriolemia is reported. It is proposed that ectopic production of the active vitamin D metabolite related to ongoing clonal expansion in the bone marrow accounts for the hypercalcemic state. Consistently low levels of circulating type I procollagen propeptide (PICP) and lack of progression of the bone marrow fibrosis during almost 6 months of follow‐up point to an in vivo inhibition of type I collagen synthesis by 1,25‐dihydroxyvitamin D3.
Presentation of antigen by mixed isotype class II molecules in normal H-2d mice.
Authors: G Ruberti, K S Sellins, C M Hill, R N Germain, C G Fathman, A Livingstone
Journal: The Journal of Experimental Medicine (1992)

A panel of DBA/2 T cell hybridomas specific for the sperm whale myoglobin epitope 110-121 was found to recognize antigen presented by the mixed isotype class II molecule E alpha dA beta d. The response was blocked by monoclonal antibodies specific for E alpha and A beta d chains; in addition, the hybridomas responded to antigen presented by L cells expressing E alpha A beta d molecules, and made no response with L cells expressing I-Ad or I-Ed molecules. Two more groups of hybridomas isolated from DBA/2 and B10.D2 mice immunized with myoglobin also recognized peptide 110-121 presented by E alpha d A beta d. Thus, although it is expressed at biochemically undetectable levels on spleen cells, the E alpha d A beta d molecule is an important presenting element in normal H-2d mice making a conventional immune response to a protein antigen. These results suggest that high levels of class II expression are not a prerequisite for T cell activation.
Safer endoscopic therapy of small-bowel diseases during double-balloon enteroscopy
Authors: M. Matsushita, M. Shimatani, K. Uchida, K. Okazaki
Journal: Endoscopy (2007)

We read with interest the article by Mensink et al. [1] on a multicenter survey of complications of double-balloon enteroscopy (DBE). The authors encountered 40 complications in 2362 DBEs (1.7 %), of which 13 occurred after 1728 diagnostic DBEs (0.8 %), and 27 occurred after 634 therapeutic DBEs (4.3 %). The complications consisted of pancreatitis (n = 7), bleeding (n = 19), perforations (n = 6), and others (n = 8). The authors concluded that the complication rate in therapeutic DBE is considerably higher than that associated with therapeutic colonoscopy. We believe that simple techniques can reduce the complication rate.
Cancer of the Breast
Authors: Donald J. Ferguson
Journal: JAMA (1980)

Traditional concepts of breast cancer and its treatment have been rudely shaken during the past 12 years, and some new or recycled notions have gained adherents before adequate evidence could be acquired. An unprejudiced review of the main issues, as a basis for safe practice, is more difficult to write now than it was when the first edition of this book was published in 1967. The authors, with 13 other contributors, have adequately represented most current opinions on all forms of treatment. They take, in general, a sensible, balanced point of view evidently based on experience. The new edition is double in number of pages. Addition of the following chapters reflects augmented concerns: "Screening," "Mammography and Thermography," "Growth Rates," "Reconstruction of the Breast," "Psychosocial Factors," and "Nursing Care." The chapter on anatomy is short and not sufficient for study by surgeons. Repetitive descriptions of lymphatics on pages 7 and 326
Medical Perspectives in Coronary Artery Surgery—A Caveat
Authors: W. BRUCE DUNKMAN
Journal: Annals of Internal Medicine (1974)

Coronary atherosclerosis is highly prevalent in the United States and is a major cause of death. Various surgical procedures for symptomatic occlusive coronary atherosclerosis have been attempted for more than a half century. Bypass grafting of the coronary arteries has been done for less than 10 years but has been more widely applied than any other procedure for occlusive coronary artery disease. Bypass grafting has already become a therapeutic intervention of considerable economic and logistic significance before its beneficial effects have been firmly established. In this article, review of the history of surgery for, and the natural history of, symptomatic coronary atherosclerosis provides a background for critical evaluation of the immediate results of coronary artery bypass grafting and the evidence bearing on its late effect on morbidity and mortality. Recommendations are formulated for the surgical management of chronic stable angina pectoris, unstable angina, Prinzmetal's angina, disease of the main left coronary artery, acute myocardial infarction and its complications, asymptomatic coronary artery disease, and valve replacement when occlusive coronary artery disease coexists.
The Common Cold: The Effect of Hot Humid Air on the Nasal Mucosa-Reply
Authors: J. Owen Hendley
Journal: JAMA (1994)

In Reply.  —Thank you for the opportunity to respond to the concerns of Mr Katzman and Dr Rosner concerning our recent work with the Rhinotherm. As we noted, many people experience temporary amelioration of symptoms associated with the common cold following steam inhalation. Our intention was to ascertain if steam inhalation would inhibit replication of virus and provide lasting benefit; we found it did not. It was not our intention to condemn the use of properly maintained vaporizers and humidifiers and thus endanger lives.  Rosner reminds us that we did not mention the beneficial effects of chicken soup in relieving cold symptoms, but we felt that such a well-established remedy didn't need further justification. We continue to advise patients with colds to use vaporizers, chicken soup, and anything else that they believe helps them feel better as long as the remedies have no serious side effects.  These letters were shown