tbuckley/cabot-search huggingface dataset:
Venous Thrombosis
Authors: Lewis Dexter
Journal: JAMA (1974)

TO OUR knowledge no example of thrombophlebitis has yet been found before the 13th century AD. In 1800, John Hull<sup>1</sup>made an exhaustive review of the medical literature for the preceding two millenia, but found no record of thrombophlebitis earlier than the one described here. Anning,<sup>2</sup>Popkin,<sup>3</sup>and, more recently, Dexter<sup>4</sup>have likewise found no case before this time. Their search includes not only the writings of Hippocrates, Erasistratus, Galen, Coelius Aurelianus, Ibn-an-Nafiz, and Avicenna but also art including bas-reliefs, statuary, carvings, paintings, figurines, jewelry, pottery, engravings and coins from ancient Egypt, Greece, Rome, Persia, Arabic countries, and South America. Thrombophlebitis is one of the few diseases not mentioned in the Bible.<sup>5</sup>Hippocrates described varicose veins with ulcers but did not describe associated edema. Bilateral edema attributed to liver or renal disease was described by Galen and others, but they never described unilateral edema or
Hospital mortality league tables
Authors: B. Jacobson
Journal: BMJ (2003)

of advice and support, but effective communication between general practitioners and occupational doctors is unfortunately uncommon. 10 A number of interventions to change workplace factors that have been shown to reduce psychological ill health include counselling, training to manage stress, cognitive behavioural therapy, and workplace support programmes.The medical profession is under ever increasing public scrutiny, and levels of accountability continue to rise.However, statistics from the UK national workplace bullying advice line show that 20% of cases are from the education sector, 12% from health care, 10% from social services, and 6-8% from the voluntary sector. 6 We need to set our own house in order and should all be striving to foster working environments free of bullies, whether in our hospitals, practices, professional organisations, or colleges.Those of us involved in teaching medical students and registrars should be mindful of the powerful effects of role modelling on impressionable learners.The authors of a survey of medical students in the United States, along with others, believe that the use of aversive methods to make students learn to behave is likely to foster insensitive and punitive behaviours that are passed down from the teacher to learner, a transgenerational legacy that leads to future mistreatment of others by those who themselves have been mistreated.This undesirable result is compounded when these behaviours are adopted and directed towards patients and colleagues. 11If we are to avoid perpetuating the harrowing experiences of bullying recently described in the BMJ by a surgical trainee in the NHS, 12 we need to lead by example.
Research Design and Statistical Methods in Chinese Medical Journals
Authors: Qian Wang
Journal: JAMA (1998)

Context.—Study design and statistical analyses have improved in journals published in Western countries, but the type of research designs and statistical methods used in medical journals outside Western countries has not been assessed.Objectives.—To determine the frequency of research designs and statistical techniques used in Chinese medical journals, types of statistical errors present, and trends over a 10-year period.Design .—Evaluation of all original articles published in 5 leading journals in 1985 (N=640) and in 1995 (N=954).Main Outcome Measures.—Research designs and statistical methods.Results.—Compared with 1985, significant improvement was seen in 1995; the percentages of original articles reporting clinical trials, prospective studies, or basic science research increased from 18% to 31% (P&lt;.001), the proportion of papers using statistical tests increased from 40% to 60% (P&lt;.001), more sophisticated statistical methods were used, and of those articles using statistics, the proportion using appropriate methods increased from 22% to 46% (P&lt;.001). In both years, the most commonly used statistical methods were t tests and contingency tables. The most common errors were presentation of P values without specifying the test used, use of multiple t tests instead of analysis of variance, and use of unpaired t tests when paired tests were required.Conclusions.—The use of statistical methods in Chinese medical journals research is improving, and by 1995, the frequency of using statistical methods in published articles was similar to the results determined in previous studies of journals. However, the lack of or inappropriate use of statistics remains a serious problem.
Ophthalmia Neonatorum in Developing Countries
Authors: Allen Foster, Volker Klauss
Journal: New England Journal of Medicine (1995)

Ophthalmia neonatorum, also called conjunctivitis of the newborn, refers to any conjunctivitis with discharge that occurs in the first 28 days of life.1 The infection may be gonococcal (caused by Neisseria gonorrhoeae), in which case it is potentially blinding, or nongonococcal, in which case the risk of blindness is low. Chlamydia trachomatis is the most important nongonococcal etiologic agent. In the 19th century ophthalmia neonatorum was the principal cause of blindness in European children.2 In 18813 Credé introduced the practice of prophylactic cleaning of the eyelids at birth, followed by the instillation of one drop of 1 percent silver . . .
New Quackery or New Clothes?
Authors: George S. Brown
Journal: JAMA (1897)

Birmingham, Ala., Sept. 16, 1897. <h3>To the Editor:</h3> —To one who takes a little dip into the history of medical quackery (there are all sorts), the methods all seem so threadbare. Each new "boon to humanity" is such a wearying repetition of the last that it would seem nothing new could possibly be developed. Perhaps this is true, but as far as one with a limited education in medical history can see, the present popular plan of the nostrum-vendors and quack discoverers within our ranks, of ignoring the laity directly and preying upon the gullible portion of the medical profession, is no less than a grand glorious inspiration. All quackeries have "worked the profession," but as a<i>specialty</i>I believe this is new. Many of us are familiar with the more conspicuous (not more successful) of these gentry, but even with the most suspicious of us in the beginning these
Propionibacterial biofilms cannot explain antibiotic resistance but might contribute to some cases of antibiotic recalcitrant acne
Authors: T. Coates, A. Eady, J. Cove
Journal: British Journal of Dermatology (2003)

Sir, Antibiotic resistance is defined as a change in susceptibility of a microorganism to an antibiotic such that a higher concentration of drug is required to inhibit growth of a resistant strain compared to a fully susceptible wild type strain. In our previous work we have defined resistance using laboratory criteria in that the minimum inhibitory concentrations (MICs) of drugs for resistant strains of Propionibacteria acnes and P. granulosum exceed those of fully susceptible strains. We have gone on to determine the molecular genetic basis of this 'acquired' resistance to erythromycin, clindamycin and tetracycline and have shown that it is mainly due to point mutations in the target site (ribosomal RNA). However, we concede that resistance defined using laboratory criteria may not be clinically relevant. Here the question is whether the MIC of the drug for the organisms exceeds concentrations that can be achieved therapeutically at the site of action. In the case of acne there are two sites that are relevant: the skin surface (from which previously sterile follicles can become infected) and the ducts of pilosebaceous follicles, both normal and lesional. Many years ago we showed that patients colonized with erythromycin‐resistant propionibacteria responded inadequately (< 50% improvement) to oral erythromycin therapy.1 In this scenario, there is absolutely no possibility that resistance is not clinically relevant; MICs of erythromycin for resistant strains (512–2048 µg mL−1) are at least 100 times higher than plasma levels on a dose of 1 g day−1.
New Methods of Pelviscopy (Gynecologic Laparoscopy) for Myomectomy, Ovariectomy, Tubectomy and Adnectomy
Authors: K. Semm
Journal: Endoscopy (1979)

The development of suitable instruments for perfect grasping, cutting, sucking, ligating and of a new system of performing hemostasis by endocoagulation through a 7–11 mm Ø trocar-sheath enables us to initiate effective endoscopical intraabdominal surgery. New surgical techniques are being investigated on > 2.000 cases of surgical pelviscopic interventions which were performed between 1973-1976. Since 1977 we have extended the endoscopical intraabdominal surgery as follows: Myomectomy (subserous), adnectomy, ovarian-cyst-resection, cystomectomy, tubectomy in case of tubal pregnancy. In 115 cases no intra- or postoperative complications have occurred. Normal postsurgical healing procedure could be checked on 18 re-pelviscopies and on 2 later laparotomies. The new technical equipment has opened us together with special surgical procedures a new era of gynecologic surgery.
Flow-cytometry phenotypic assessment of immune cell subsets reflecting function for the identification of breast cancer patients receiving vaccine plus docetaxel with longer progression-free survival
Authors: Italia Grenga, Renee N Donahue, James L Gulley, Christopher Heery, Ravi A Madan, Jeffrey Schlom, Benedetto Farsaci
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts Aim of this study was to assess whether specified immune cells subsets at baseline could help identifying patients with longer progression-free survival (PFS) in a clinical trial of metastatic breast cancer patients receiving docetaxel±vaccine. We applied flow-cytometer analysis
New Strategies in Acute Promyelocytic Leukemia: Moving to an Entirely Oral, Chemotherapy-Free Upfront Management Approach
Authors: Amer M. Zeidan, Steven D. Gore
Journal: Clinical Cancer Research (2014)

Incorporation of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) into the management paradigms of acute promyelocytic leukemia (APL) has markedly improved outcomes. Significant progress occurred in understanding the molecular pathogenesis of APL. ATO, in contrast with ATRA, is capable of eradicating the APL-initiating cells and can result in cure. Preclinical and clinical data confirmed the synergy of ATO and ATRA, and the ATRA-ATO combination was proved noninferior to a standard ATRA-chemotherapy regimen in patients with non-high-risk APL. Oral formulations of arsenic exhibited excellent activity in advanced clinical testing and their combinations with ATRA offer an opportunity for a completely oral, chemotherapy-free regimen for curing APL. Nonetheless, significant challenges remain. Reducing early death due to bleeding complications is an important area of unmet need. Data suggest that delays in initiation of ATRA upon suspecting APL continue to occur in the community and contribute to early mortality. Questions remain about the optimal place and schedule of arsenic in the therapeutic sequence and the role of the oral formulations. Refining the role of minimal residual disease in directing treatment decisions is important. Development of novel targeted agents to treat relapsed disease requires deeper understanding of the secondary resistance mechanisms to ATRA and ATO.
Infant AIDS Prevention Study Finally Gets Going
Authors: Paul Cotton
Journal: JAMA (1993)

AFTER MORE than a year's delay, an agent that may prevent transmission of the human immunodeficiency virus (HIV) from mothers to infants is finally being evaluated in a clinical trial. The hope is that HIV immunoglobulin (HIVIG), an immunoglobulin preparation containing antibodies to HIV, will prevent transmission from mother to child in the same way that similar products containing antibodies to hepatitis B or cytomegalovirus prevent transmission of those viruses. The study represents one of the first concerted efforts to try to boost the immune system response to HIV, rather than to use antiviral drugs alone, says Claude Lenfant, MD, director of the National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Md. The trial was set to begin in July of 1992 when the HIVIG supplier, Abbott Laboratories, North Chicago, Ill, demanded complete protection from any legal liability, which would have required an act of Congress (<i>JAMA</i>. 1992;268:1987-1992). Abbott said
Beware shifts in case mix under the block contract.
Authors: G. Neil-Dwyer, P. D. Lees, M. Claxton, J. Lewis
Journal: BMJ (1992)

Opioid receptors (ORs) and their mRNA are present in the central and peripheral nervous systems of mammals and in different peripheral tissues, including the gut. Using a model of croton oil-induced (CO) intestinal inflammation in mice, we have shown a 6-fold increase in the potency of the antitransit and antisecretory effects of μ-OR agonists, mediated by peripheral ORs. We postulate that the enhanced effects are mediated by an increase in the expression of intestinal OR. We used jejunum (stripped of the mucosal layer) from mice with CO-induced intestinal inflammation and, as control subjects, saline-treated animals (SS). We evaluated the quantity of μ-OR mRNA determined by a competitive reverse-transcriptase polymerase chain reaction; the levels of μ-OR protein by Western blot immunoassay, and the localization and number of cells expressing μ-OR using immunohistochemistry. The results show a significant increase of μ-OR mRNA (7.7-fold) and receptor protein (3-fold) during intestinal inflammation. Inflammation also induced a 64.3% increase in the number of neurons expressing μ-OR immunoreactivity in the myenteric plexus but not in the submucosal plexus. Our results show that intestinal inflammation enhances the transcription and translation of μ-OR mRNA, thus explaining the increased potency of μ-opioids during inflammation.
Life-table for cystic fibrosis.
Authors: D. J. Mantle, A. P. Norman
Journal: BMJ (1966)

Life-tables can be of value in assessing the social problem which a disease presents and in evaluating the success of different methods of treatment.Two methods of constructing a lifetable are available if a hospital series is used: (1) entering the patient from the age at proved diagnosis, and (2) entering the patient from birth.The first method will probably overestimate mortality, especially when diagnosis tends to be made shortly before death.The second will probably underestimate mortality, except in surveys of specific geographical areas in which all patients with the disease may be expected to be ascertained.Cystic fibrosis is the commonest autosomal recessively determined disease of childhood.The best estimate of incidence in children of European stock is probably that of Danks, Allan, and Anderson (1965), which gives an incidence of approxi- matelv I in 2,400 live births. Source of Case MaterialA survev has been made of 498 children attending the Hospital for Sick Children between 1943 and midsummer 1964 who were coded in the hospital records as suffering or possibly suffering from cystic fibrosis.One further case was identified from a search of the post-mortem index, giving a total of 499 cases.Of these cases 399 were coded as suffering from cystic fibrosis and 100 from cystic fibrosis presenting with meconium ileus.Below are given the clinical and laboratory data resulting from the invesigation.1. Diagnosis first confirmed by the sodium content of the sweat -93 cases.(In 21 the diagnosis was subsequently also confirmed by the tryptic activity of the duodenal juice.In seven cases the tryptic activity of the duodenal juice was non-confirmatory.)2. Diagnosis first confirmed by the tryptic activity of the duodenal juice-163 cases.(In 39 the diagnosis was subsequently also con- firmed by the sodium content of the sweat.) 3. Diagnosis not confirmed by either test, since neither test was done-105 cases.4. Diagnosis regarded as not confirmed by laboratory tests-27 cases: duodenal juice confirmatory but sweat test non-confirmatory, 2 cases; duodenal juice non-confirmatory, sweat test not done, 17 cases; sweat test non-confirmatory, duodenal juice not examined,
<i>In vivo</i>antisense oligonucleotide reduction of NPC1 expression as a novel mouse model for Niemann Pick type C- associated liver disease
Authors: Victoria M. Rimkunas, Mark J. Graham, Rosanne M. Crooke, Laura Liscum
Journal: Hepatology (2008)

Niemann-Pick type C (NPC) is a fatal autosomal recessive lipidosis that is characterized by lysosomal storage of cholesterol and glycosphingolipids. Patients exhibit prolonged neonatal jaundice, hepatosplenomegaly, and progressive neurodegeneration that generally result in death by the teen years. Most clinical cases are caused by mutations in the NPC1 gene. Current mouse models of NPC are not well suited for studying the liver disease due to the rapidly progressing neurological disease. To facilitate study of NPC-associated liver dysfunction, we have developed a novel mouse model using antisense oligonucleotides to ablate NPC1 expression primarily in the liver. Here, we show that the NPC1 knockdown leads to a liver disease phenotype similar to that of patients with NPC and the NPC(nih) mouse model. Key features include hepatomegaly, lipid storage, elevated serum liver enzymes, and increased apoptosis.This novel NPC1 antisense mouse model will allow delineation of the mechanism by which NPC1 dysfunction leads to liver cell death.
Abstract 4580: Proteinuria and Reduced Glomerular Filtration Rate Independently Increase Risk of Thromboembolism in Atrial Fibrillation: The ATRIA Study
Authors: Alan S Go, Margaret C Fang, Natalia Udaltsova, Yuchiao Chang, Leila H Borowsky, Niela K Pomernacki, Daniel E Singer
Journal: Circulation (2008)

Atrial fibrillation (AF) substantially increases the risk of ischemic stroke but this risk varies among patients with AF. Existing stroke risk stratification schemes have limited predictive ability. Chronic kidney disease is a major cardiovascular risk factor, but whether it independently increases the risk for stroke in AF is unknown. In a large, diverse cohort of adults with nonvalvular atrial fibrillation, we examined how chronic kidney disease (i.e., reduced glomerular filtration rate or proteinuria) affects risk of thromboembolism off anticoagulation in patients with AF. We estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation and proteinuria from urine dipstick results found in laboratory databases. Data on patient characteristics, stroke risk factors, longitudinal use of warfarin therapy, and thromboembolic events between 1996 –2003 were ascertained from validated clinical databases. Thromboembolic events (ischemic stroke and other systemic embolism) were confirmed by chart review. We used multivariable Poisson regression to evaluate the independent association between reduced eGFR and documented proteinuria with risk of thromboembolic events off warfarin therapy. During 33,165 person-years off anticoagulation among 13,535 patients with AF and no prior dialysis or renal transplant, we observed 676 incident thromboembolic events. After adjustment for known risk factors for stroke and level of eGFR, proteinuria increased the risk of thromboembolism by 54% (adjusted relative risk [RR] 1.54, 1.28 to 1.84). Independent of proteinuria and other confounders, there was a graded, increased risk of stroke associated with progressively lower eGFR compared with eGFR ≥60 (in units of ml/min/1.73 m 2 ): adjusted RR 1.16 (95% CI: 0.95 to 1.40) for eGFR 45– 59, and RR 1.39 (1.12 to 1.71) for eGFR &lt;45 (P=0.001 for trend). Chronic kidney disease increases the risk of thromboembolism in AF independent of other stroke risk factors. Knowing the level of kidney function and presence of proteinuria can potentially improve risk stratification for decision-making about the use of antithrombotic therapy for stroke prevention in AF.
VALUE OF METHYLENE BLUE IN OPERATING ON FISTULOUS TRACTS.
Authors: THEO. G. DAVIS
Journal: JAMA (1902)

On June 23, 1901, I was called by Dr. S. to see Miss B., aged 43, she having had during the previous winter an abscess, situated between the right tuberosity of ischium, and anus, opened and twice operated on by a Philadelphia surgeon. This had refused to heal. On examination, a line of scar tissue was found to extend from the outer side of the anal sphincter almost to the ischial tuberosity; about the center of the scar was a small opening from which oozed pus and the margins of which were undermined and unhealthy. A probe passed upward and outward into the right ischio-rectal fossa, a distance of three and one-fourth inches, but no opening into the rectum could be detected at this examination. The tract was cleaned by hydrogen dioxid and water, equal parts, and afterward with alcohol 50 per cent.; this was continued for about two weeks,
Epidurals’ Benefit for Back Pain Questioned
Authors: Tracy Hampton
Journal: JAMA (2007)

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Has My Patient Responded?
Authors: Thomas E. Dolmage, Kylie Hill, Rachael A. Evans, Roger S. Goldstein
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

To correctly interpret clinical measurements it is necessary to understand the standard deviation and the standard error; the former reflects the range or variability of individuals within a sample and the latter reflects the precision for which the group parameters have been estimated. When evaluating an individual patient, test measurement properties such as repeatability will assist in concluding whether a repeated test, measured to monitor the response to an intervention, has changed beyond its natural variability. Using the “best” test has an inherent bias and ignores the natural test variation, whereas the average of repeated tests is more representative of the true value, making it more discriminative to change. Serial measurements to follow progress will increase a clinician's confidence in the observed effects of treatment.