tbuckley/cabot-search huggingface dataset:
If only lottery winnings were randomly assigned
Authors: I. Walker
Journal: BMJ (2002)

EDITOR—The causal effect of income on health has important policy implications, and yet its identification is dogged by the problem of income not being randomly assigned. Researchers continue to ignore this, including Rodgers in his editorial,1 but the idea that the problem can be overcome by exploiting lottery winnings as a “natural experiment”2 is superficial because winners are not randomly selected from the population since playing is not a random event.

Although playing is …
Incidence of large oesophageal varices in patients with cirrhosis: application to prophylaxis of first bleeding.
Authors: P Cales, H Desmorat, J P Vinel, J P Caucanas, A Ravaud, P Gerin, P Brouet, J P Pascal
Journal: Gut (1990)

Because several studies have suggested that beta blockers are effective in the prophylaxis of first variceal bleeding in cirrhosis, screening for oesophageal varices might be appropriate. We prospectively studied 84 cirrhotic patients without obvious evidence of large oesophageal varices and previous bleeding during a mean follow up of 16 months. At entry to the study 41 patients had no oesophageal varices and in 43 these were grade 1. The subsequent percentages of patients without large oesophageal varices were 74% at one year and 52% at two years. Univariate analysis showed that a longer duration of cirrhosis (p less than 0.05) and grade 1 oesophageal varices at entry (p less than 0.001) were predictive factors for the occurrence of large oesophageal varices, whereas, multivariate analysis showed that the initial size of the oesophageal varices (p less than 0.001), a high initial Child-Pugh score, and a smaller improvement in Child-Pugh score during the study were independent risk factors. Among patients with grades 0 and 1 oesophageal varices at the start of the study the proportions with large oesophageal varices at two years were 31% and 70% respectively. We have calculated that, accepting a maximum risk of first bleeding of 10% without prophylactic treatment, a patient without oesophageal varices should be screened endoscopically every other year, while a patient with grade 1 disease should benefit from one annual upper gastrointestinal endoscopy.
Lymphangiography: Diagnosis of Nodal Metastases From Testicular Malignancies
Authors: Sidney Wallace
Journal: JAMA (1970)

In preparation for a discussion of our experience with lymphangiographic diagnosis in testicular malignancies, a description of the embryology and anatomy of the testicle and its lymphatic drainage is of value. <h3>Embryology.—</h3> The urogenital fold ultimately extends from C-6 to S-2. The ridge divides into a lateral mesonephric fold and a medial genital fold, the primordium of the genital gland. The testicle descends from the para-aortic region to the scrotum. Gonadal tissue may exist anywhere along this distribution. <h3>Lymphatic Drainage.—</h3> Testicular lymphatics accompany the internal spermatic artery and vein and drain into the lumbar nodes. The right trunks terminate in the right lumbar glands which lie between the level of the aortic bifurcation and the renal vein. In 10%, these trunks end in a node in the angle between the right renal vein and the inferior vena cava.<sup>19</sup>The left testicular lymphatics drain into the para-aortic nodes near the
HOW TO PLACE LENSES BEFORE THE EYES SO THAT DISTANCE OF THEIR RESPECTIVE ANTERIOR FOCI SHALL BE THE SAME.
Authors: MARK D. STEVENSON
Journal: JAMA (1900)

Not every ophthalmologist seems to realize the extreme importance of having the anterior focus of each eye at exactly the same distance, and many who try to obtain this fail because of the improper methods used.  If the anterior focal points are not exactly at the same place the ciliary muscles in their ceaseless efforts to find a position of rest will be under a constant seesaw. Every ophthalmologist finds cases in which comfort and good vision can be obtained for each eye separately, yet when the patient looks with both eyes, he complains of discomfort and dizziness and of not being able to see clearly. The problem is how to remedy this.  Many patients with glasses have the same visual acuity in each eye. After refracting such cases, and while they view distant test-types with both eyes, I take a plus and minus sphere of .25 diopter strength and place
Soluble CD40L in Young Type 1 Diabetic Individuals Without Clinical Microvascular and Macrovascular Complications
Authors: Giovanni Targher, Giacomo Zoppini
Journal: Diabetes Care (2004)

The past decade has been characterized by growing interest in the idea that atherosclerosis is an inflammatory disease. Interaction of the multipotent immunomodulator CD40 ligand (CD40L) with its receptor CD40 has emerged as an important contributor to the inflammatory processes that lead to atherosclerosis and thrombosis. CD40 and CD40L are expressed on endothelial and smooth muscle cells, monocytes, and platelets, and CD40-CD40L interaction has been shown to promote a wide array of prothrombotic and inflammatory effects both in vitro and in vivo (1). In addition to the cell-associated form, CD40L also exists in a soluble form, which is fully active biologically, termed soluble CD40L (sCD40L). Elevated sCD40L levels are found in patients with acute coronary syndromes (2) and are predictive of increased risk of future cardiovascular events in clinically healthy women (3).

At present, little is known regarding the impact of the diabetic state itself on sCD40L levels, particularly in type 1 diabetic patients. It has been reported …
Diabetic Ketoacidosis During Long-Term Treatment with Continuous Subcutaneous Insulin Infusion
Authors: Norman R Peden, Jan T Braaten, J B Ralph Mckendry
Journal: Diabetes Care (1984)

During 1880 patient-months of treatment with continuous subcutaneous insulin infusion in 101 patients with IDDM, 36 episodes of acute, severe loss of glycemic control, including 29 with significant ketoacidosis, occurred in 20 patients. Fifteen episodes were attributable to failure of insulin delivery to the patient while 13 were precipitated by infection. Insufficiently frequent blood glucose monitoring, failure by patients to detect mechanical and technical problems with infusion systems, failure to adhere to “sick day” regimens, and delay in seeking medical help all contributed to the progression of a number of episodes. Thirst, nausea, and vomiting were the common clinical manifestations of decompensation; and the degree of acidemia was often mild in relation to the degree of hyperglycemia. Response to conventional management was usually prompt.
The Milk-Alkali Syndrome, Vitamin D, and Parathyroid Hormone
Authors: Thomas R. Dorsch
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 November 1986The Milk-Alkali Syndrome, Vitamin D, and Parathyroid HormoneTHOMAS R. DORSCH, M.D.THOMAS R. DORSCH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-5-800 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The milk-alkali syndrome is an uncommon cause of hypercalcemia in current practice. The pathophysiology of the syndrome has been described, but many uncertainties about calcium-regulating hormones exist (1). I recently evaluated a patient whose findings may help define this problem.A 52-year-old white woman was referred to St. Francis Medical Center for evaluation of renal insufficiency in May 1984. She consulted her physician because of nausea, vomiting, and a 4.5-kg weight loss in the preceding 6 months. Intermittent burning epigastric and retrosternal pain had been noted after meals for 8 years and was relieved with antacid tablets...References1. ORWOLL E. The milk-alkali syndrome: current concepts. Ann Intern Med. 1982;97:242-8. LinkGoogle Scholar2. SCHUMANJONES CH. The "milk-alkali" syndrome: two case reports with discussion of pathogenesis. Q J Med. 1985;55:119-26. MedlineGoogle Scholar3. BROADUSHORSTLANGLITTLEDIKERASMUSSEN ARREH. The importance of circulating 1,25-dihydroxyvitamin D in the pathogenesis of hypercalciuria and renal-stone formation in primary hyperparathyroidism. N Engl J Med. 1980;302:421-6. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Illinois College of Medicine Peoria, IL 61656-1949 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMilk-Alkali SyndromeMilk Alkali Syndrome and the Dynamics of Calcium HomeostasisMilk-Alkali Syndrome: A Historical Review and Description of the Modern Version of the SyndromeCalcium Carbonate Toxicity: The Updated Milk-Alkali Syndrome; Report of 3 Cases and Review of the LiteratureMilk-Alkali Syndrome from Ingestion of Calcium Carbonate in A Patient with HypoparathyroidismAdverse Effects of High-Calcium Diets in HumansMilk-Alkali Syndrome Associated with Calcium Carbonate Consumption: Report of 7 Patients with Parathyroid Hormone Levels and an Estimate of Prevalence Among Patients Hospitalized with Hypercalcemia 1 November 1986Volume 105, Issue 5Page: 800-801KeywordsHormonesHypercalcemiaNauseaPainParathyroid hormoneVitamin DVomitingWeight loss Issue Published: 1 November 1986 PDF DownloadLoading ...
TOXIC HYPERTHYROIDISM OF NASAL ORIGIN
Authors: Simon L. Ruskin
Journal: JAMA (1924)

It is acknowledged that toxic hyperthyroidism of nasal origin exists, and yet one frequently encounters cases that have had every other conceivable search for focal infection without a thorough investigation of the nasal accessory sinuses. In the case here reported, the patient was under care for four years without receiving a nasal examination. <h3>REPORT OF CASE</h3> B. D., a man, aged 54, a shoemaker, had complained for twenty years of dyspnea and cough, associated with persistent heaviness of the chest. For about five years prior to the onset of his present trouble, he had had asthma, which cleared up after a severe attack of vomiting. During the last fifteen years, he had had attacks of grip twice a year, each of which necessitated his staying in bed for several days. These attacks were always associated with severe colds in the head and with a profuse mucous discharge, which passed into
Effects of Tamoxifen Therapy on Lipid and Lipoprotein Levels in Postmenopausal Patients With Node-Negative Breast Cancer
Authors: R. R. Love, P. A. Newcomb, D. A. Wiebe, T. S. Surawicz, V. C. Jordan, P. P. Carbone, D. L. DeMets
Journal: JNCI Journal of the National Cancer Institute (1990)

We conducted a 2-year, randomized, double-blind, placebo-controlled toxicity trial of therapy with tamoxifen (10 mg twice a day) in 140 postmenopausal women with a history of breast cancer and histologically negative axillary lymph nodes. These women had been treated with surgery with or without radiotherapy. At a 3-month evaluation, tamoxifen-treated women showed a significant decrease in fasting plasma levels of total cholesterol and low-density lipoprotein (LDL) cholesterol, which persisted at 6- and 12-month evaluations. During the first 12 months, plasma triglyceride levels increased; small but significant decreases in high-density lipoprotein cholesterol (HDL) were observed in tamoxifen-treated women, but ratios of total cholesterol to HDL cholesterol and of LDL to HDL cholesterol changed favorably. While data relating lipid/lipoprotein profiles and cardiovascular disease are limited in women, current evidence suggests that total cholesterol and possibly low-density lipoprotein cholesterol are risk factors. We conclude that during the first 12 months of treatment, tamoxifen exerts a favorable effect on the lipid profile in postmenopausal women with early stage breast cancer. [J Natl Cancer Inst 82:1327–1332, 1990]
Is the BMA division really necessary?
Authors: N Ellis
Journal: BMJ (1980)

Since joining the BMA staff just over a year ago I have spoken at over 80 local meetings of doctors. No doubt the motives behind the invitations from divisions, regional councils, and local craft committees were varied. For some, the newly appointed senior industrial relations officer was being called upon to explain himself, and for others a new face from BMA House probably filled a gap in last year's programme. I had not been in BMA House long before I heard stories of eminent speakers who had traversed the country to address 10 members. Such dismal tales are not peculiar to the BMA. My experience has crossed the range of nine to 90 doctors. Un doubtedly the element of sociability, especially if refreshments are available, has attracted many members to these functions. But it's only fair to add that those meetings which left the strongest impression on me have often been attended by no more than a handful of doctors. The discussion at these poorly attended meetings was informal and frank, and usually turned on the question why so few members had bothered to come. The BMA was born in the provinces as a reaction against the nineteenth century dominance of medicine by London doctors and so the division has played a vital part in the BMA's develop ment. In many areas it still is doing so but it has nevertheless lost important traditional functions. Since the advent of post graduate medical centres its previous role as a forum for scien tific and learned activities has declined. In addition, the intro duction of strengthened and autonomous craft committee structures has removed much medicopolitical activity from the division's purview.
Methadone and Chemotherapy in Drug Addiction
Authors: John N. Chappel
Journal: JAMA (1974)

ATTEMPTS to characterize alcohol and other drug addictions as diseases have been seriously challenged. Szasz<sup>1-3</sup>claims that addiction is a moral, not a medical problem, and he boldly states that "bad habits are not diseases." He implies that doctors should not be involved in treating addicted individuals and suggests that the solution lies in repealing all drug laws, including prescription statutes. Conceptual and attitudinal problems continue to cloud the picture. Emphasis is shifting from the use of specific chemicals to the person and his or her problems. Negative labels such as "addict" and "alcoholic," which may lead physicians and other helpers to give up on or reject an individual, are being replaced by more neutral terms such as "drug dependence." Wikler4 cites the World Health Organization (WHO) definition that drug dependence is A state, psychic and sometimes physical, resulting from the interaction between a living organism and a drug,
Thyroid Supplements and Breast Cancer
Authors: Karl B. Hansen
Journal: JAMA (1976)

To the Editor.—  The article by Kapdi and Wolfe warrants comment.  The data presented imply that the entire group of subjects (5,505) was homogenous. This implies all exogenous drug intake was the same and that all groups were matched for age, race, environmental factors, and parity, and that the only variable was the presence of thyroid supplements. Such an assumption seems unfounded, and the implied conclusion of a relationship between thyroid supplementation and breast cancer totally unfounded.  To adequately evaluate such an assumption would require a careful scrutiny of the factors cited as possible variables in addition to the evaluation of the thyroid status in both treated and untreated groups. It may be possible from such a study to determine incidence of breast carcinoma in patients who are euthyroid, who are hypothyroid, and those who are hyperthyroid. These should be grouped by age, parity, and other drug history such as
Pulmonary function in coal workers with Caplan's syndrome and non-rheumatoid complicated pneumosoniosis.
Authors: K Constantinidis, A W Musk, J P Jenkins, G Berry
Journal: Thorax (1978)

This retrospective study compares the pulmonary function of 24 coal workers with Caplan9s syndrome with that of 36 subjects with non-rheumatoid progressive massive fibrosis (PMF). Allowing for differences in radiographical category, age, years worked underground, and smoking, obstruction to air flow as reflected in the one-second forced expiratory volume, the vital capacity, and the ratio of residual volume to total lung capacity, was significantly less in subjects with Caplan9s syndrome. No significant differences in transfer factor were found. These findings may be explained by the different pathological features of the two entities. Selection bias does not appear to be responsible for the differences observed between the groups, but studies designed to eliminate this would be desirable.
Tuberculosis and social exclusion: Do developed countries really need new strategies?
Authors: Ulf R Dahle
Journal: BMJ (2006)

Editor-Walker et al show convincingly that drivers and other occupants of heavy four wheel drive vehicles are safer in crashes than those in smaller or lighter vehicles and those on foot or cycle. 1 They also show that drivers of these vehicles use mobile phones more often and seat belts less often than drivers of other cars.But by conflating mobile phone use (which distracts drivers) and non-use of seat belts (which makes drivers feel less safe) as equally important examples of illegal and dangerous practices they have sown confusion and undermined the prospect of a constructive approach to road safety.Using mobile phones and not using seatbelts have opposing consequences for other road users.The distraction caused by mobile phones increases the threat to others, but the non-use of seat belts decreases it.As the authors note, deaths of pedestrians, cyclists, and rear seat passengers increased (by 8%, 13%, and 28% respectively) after laws mandating the use of seat belts in front seats were introduced in the United Kingdom.
GMC clears doctors who signed cremation forms for Shipman
Authors: Owen Dyer
Journal: BMJ (2005)

Four GPs who signed the cremation forms of patients murdered by serial killer Harold Shipman have been cleared of serious professional misconduct by the General Medical Council.

Doctors Jeremy Dirckze, Stephen Farrar, Alastair MacGillivray, and Susan Booth, who all worked close to Dr Shipman's surgery in Hyde, Greater Manchester, between them signed 214 cremation form Cs for Dr Shipman's deceased patients between 1979 and 1997. Of these, 124 were later found to have been unlawfully killed.

The four GPs were accused …
Lichen sclerosus associated with perineal urethrostomy
Authors: T.N. Shim, D.E. Andrich, A.R. Mundy, C.B. Bunker
Journal: British Journal of Dermatology (2013)

Funding sources: Skin Treatment and Research Trust (START) and Sir John Fisher Foundation. Conflicts of interest: none declared. Dear Editor, We welcome the paper by Al‐Niaimi and Lyon1 describing periurostomal lichen sclerosus (LSc). Their findings further bolster the theory that has been promulgated by C.B. Bunker (C.B.B.) for the past decade that genital LSc is due to occluded exposure of susceptible epithelium to urine. We proffer more support for this hypothesis: three cases of LSc occurring around perineal urethrostomies. Patient 1 is a 63‐year‐old man (with hypertension and type 2 diabetes mellitus) who presented with irritation, pallor and atrophy of the perineal skin radiating circumferentially for several centimetres around a urethrostomy. This had been performed for end‐stage management of a 14‐cm distal urethral stricture due to LSc for which he had previously received two unsuccessful urethral dilatations. Patient 2 is a 77‐year‐old man (with hypertension and hyperlipidaemia) who presented with intermittent soreness, sclerosis and fissures with underlying erythema around a perineal urethrostomy (Fig. 1a). He had previously been treated for panurethral LSc by optical urethrotomy followed by self‐dilatation. However, perineal urethrostomy was necessary because recurrent stricture caused occlusion at the penoscrotal junction.
The Evolution of Scientific and Medical Journals
Authors: Elliot M. Berry
Journal: New England Journal of Medicine (1981)

To the making of many books there is no end.— Ecclesiastes XII, V.12.In the beginning was the General Scientific Journal. And the General Scientific Journal begat the Specialty Journal, and the Specialty Journal begat the Subspecialty Journal. And the Subspecialty Journal begat the Single-Subject Journal, whether according to class of compound, specific disease, or methodology. And the Single-Subject Journal begat the Interdisciplinary Journal to link up the specialties separated at an earlier evolutionary date. And the scientific community saw that the journals were good, and they were fruitful and multiplied. So the National Journals (e.g., British, American, and . . .
Premature development of erosive osteoarthritis of hands in patients with chronic renal failure.
Authors: I J Duncan, N P Hurst, R Sebben, S C Milazzo, A Disney
Journal: Annals of the Rheumatic Diseases (1990)

The prevalence of grade III or IV osteoarthritis was determined in 210 patients with chronic renal failure, of whom 94 were receiving chronic haemodialysis and 116 had functioning renal transplants. The prevalence of grade III or IV osteoarthritis was three times greater in patients under 65 than in a control population, and all but two affected patients also had erosion of subchondral bone in at least one affected joint. The excess of osteoarthritis was apparent in both the transplant recipients and those receiving haemodialysis. Over the age of 65 there was no significant difference in prevalence. Metabolic bone disease, including osteopenia, might contribute to the development of erosive osteoarthritis in chronic renal failure.
Trp53 inactivation in the tumor microenvironment promotes tumor progression by enhancing pro-inflammatory tumor stromal populations
Authors: Gang Guo, Luis Marrero, Augusto Ochoa, Yan Cui
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts Inactivation of the tumor suppressor p53 is one of the leading causes of cancer as p53 inactivation via somatic mutations occurs in 50% of human cancers and sometimes in fibroblasts within the tumor microenvironment (TME). Recent studies by our laboratory and others suggest that
Double-blind challenge tests with food additives in chronic urticaria
Authors: J.K. Kellett, P.J. August, M.H. Beck
Journal: British Journal of Dermatology (1984)

Journal Article Double‐blind challenge tests with food additives in chronic urticaria Get access J.K. Kellett, J.K. Kellett The Skin Hospital, Manchester Search for other works by this author on: Oxford Academic Google Scholar P.J. August, P.J. August The Skin Hospital, Manchester Search for other works by this author on: Oxford Academic Google Scholar M.H. Beck M.H. Beck The Skin Hospital, Manchester Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 111, Issue s26, 1 July 1984, Page 32, https://doi.org/10.1111/j.1365-2133.1984.tb05254.x Published: 01 July 1984