tbuckley/cabot-search huggingface dataset:
Short-leg syndrome.
Authors: F Vogel
Journal: BMJ (1971)

Short-leg syndrome, or asymmetry of length in the lower extremities, is a common orthopedic problem in children. It is vital to recognize normal bone function, bone growth, and potential growth when evaluating this syndrome. Classification of this problem is either structural or functional. Structural (real) short legs usually have trauma or congenital growth inequality as their etiology. Functional (apparent) short legs usually result from soft tissue contractures or foot function aberrations. The child's age determines the extent of our examination. The lower extremity should be segmented during examination to help determine the location of pathology. Measuring the deformity requires precise scientific procedures. The level of compensation must be determined. Foot, pelvic, and spinal compensations should be evaluated. Scanograms or orthoroentgenograms are useful in diagnosing, quantifying, and prognosing short-leg syndrome. Prediction of the projected discrepancy is accomplished by the Anderson et al. remaining growth charts. Common etiologic considerations include congenital, neuromuscular, infection, trauma-induced, and tumor-caused disorders. Treatment of short-leg syndrome is determined by classification. Structural problems may need heel elevation or a combination of heel elevation and orthotic control on a conservative basis. Functional problems may require neutral position control of the feet with orthotics and correction of soft tissue contractures. Resin foam or orthopedic shoe adjustment may be used in moderate discrepancies. Structural leg inequalities may be corrected by surgical epiphysiodesis. This bone growth retardation procedure is normally performed on the long limb in pediatric patients. Therapy is directed at correcting pelvic obliquity, gait and postural aberration. The end result should be a child with cosmetically acceptable and normal functioning lower extremities.
Merck to pay $58m in settlement over rofecoxib advertising
Authors: Fred Charatan
Journal: BMJ (2008)

Google, the search engine giant, has launched Google Health, a free service for patients offering a personal electronic medical record (www.google.com/health).But the move has prompted fears over the security of health information stored in this way.President George Bush has promoted electronic health records as a means of reducing medical errors and cutting the costs of health care in the United States.But uptake has so far been slow.The new Google service will compete with similar services offered by other commercial internet health services, such as WebMD.Electronic medical histories are also stored by major health insurance companies.An individual will be able to create an account, protected by a password, and enter personal medical records, either by keying them in or by importing electronic records from hospitals, laboratories, and pharmacies that are Google Health partners.When new information is added the service will check for potential interactions between drugs, allergies, and conditions.Patients can also search for doctors by specialty or location and for hospitals, and they can permit their doctors or others to see their medical information and add to it.The New York Times reported that the service was popular when tested among patients at the Cleveland Clinic in Ohio earlier this year (www.nytimes.com,20 May, "Google offers personal health records on the web").The system allowed clinic patients to add information when they saw doctors who were not affiliated with the clinic, said Martin Harris, the clinic's chief information officer.But Pamela Hartzband and Jerome Groopman, both from Harvard University, complained in the New England Journal of Medicine in April (2008;358:1656-8) that electronic health records have led to a sea of results being pasted from previous records, instead of being focused and selective.Furthermore, they said that electronic records have "become a powerful vehicle for per-Fears over security as Google launches free electronic health records service for patients UK NEWS Finding a solution to hospital associated infections, p 1210 World NEWS Italian police arrest drug officials over alleged falsification of data, p 1208 bmj.com
Cardiovascular Problems: Perspectives and Progress
Authors: Massimo Calabresi
Journal: JAMA (1976)

In this volume are 36 chapters, grouped in 13 subdivisions, with three lively panel discussions. About one half of the text is devoted to different aspects of coronary heart disease. Some contributions review selected topics (eg, rheumatic fever, cardiac transplantation, or normal murmurs), others survey the literature (eg, myocardial imaging or pharmacokinetics of the antiarrhythmic agents and of digoxin and digitoxin), and others summarize original work by the author and co-workers (eg, alcoholic cardiomyopathy or systolic time intervals and echocardiography in coronary heart disease).  In general, the quality of these presentations is good, sometimes excellent. Admittedly, I must differ from some of the expressed opinions, and I am more moderate in the enthusiastic acceptance of some procedures. Various contributors also maintain contrasting opinions regarding the importance of congenital vs environmental factors in the pathogenesis of atherosclerosis. These differences of opinion do not detract but rather increase the value of the
COMPARISON OF CLINICAL OUTCOME AFTER BYPASS SURGERY VERSUS ENDOVASCULAR THERAPY IN PATIENTS WITH CRITICAL LIMB ISCHEMIA FOR INFRAINGUINAL ARTERY DISEASE: A PROPENSITY SCORE ANALYSIS
Authors: Yoshimitsu Soga, Shinsuke Mii, Osamu Iida, Jin Okazaki, Terutoshi Yamaoka
Journal: Journal of the American College of Cardiology (2013)
Surgical checklist reduces complications by one third
Authors: P. Moszynski
Journal: BMJ (2009)

A simple surgical checklist can lower the incidence of deaths and complications after surgery by one third, according to research published by the World Health Organization ( New England Journal of Medicine 2009 Jan 14, doi:10.1056/NEJMsa0810119).

A study of hospitals in six WHO regions shows that the rate of serious complications after surgery fell from 11% in the baseline period to 7% after introduction of the checklist, a reduction of one third. Deaths among inpatients after big operations fell by more than 40% (from 1.5% to 0.8%).

Data were collected from 7688 patients—3733 before the checklist was introduced and 3955 after.

The study was carried out in hospitals in rich …
Opt-Out Testing for Human Immunodeficiency Virus in the United States
Authors: John G. Bartlett, Bernard M. Branson, Kevin Fenton, Benjamin C. Hauschild, Veronica Miller, Kenneth H. Mayer
Journal: JAMA (2008)

The Centers for Disease Control and Prevention (CDC) has recommended human immunodeficiency virus (HIV) testing for all persons aged 13 to 64 years in all health care settings. Signed consent would not be required and counseling with referral would be managed as it is for other serious conditions. The goal of the recommendations is to promote earlier entry into care to reduce unnecessary mortality and facilitate prevention by behavioral changes that accompany knowledge of serostatus. Concerns about the change include laws in some states that mandate signed consent and counseling, a perception that counseling is an effective prevention strategy, variability in payment coverage for the test, concerns about the stigma and discrimination that may accompany the HIV diagnosis, and the possibility that other testing policies would be more effective. Eleven of 16 states have changed legislation to reduce barriers to testing, 35 of 74 national professional societies have endorsed the new recommendations, and multiple demonstration projects have shown feasibility. Metrics to evaluate the health outcomes of the CDC's recommendations for HIV testing have been defined, but the data necessary to determine the effects on early entry into care, the actual reduction in disease incidence, and the unanticipated consequences are not yet available.
Allelic origin of the abnormal prion protein isoform in familial prion diseases
Authors: Shu G. Chen, Plero Parchi, Paul Brown, Sabina Capellari, Wenquan Zou, Elizabeth J. Cochran, Cindy L. Vnencak-Jones, Jean Julien, Claude Vital, Jacqueline Mikol, Elio Lugaresi, Lucila Autilio-Gambetti, Pierluigi Gambetti
Journal: Nature Medicine (1997)
THE IN VIVO INTERACTION BETWEEN STAPHYLOCOCCUS BACTERIOPHAGE AND STAPHYLOCOCCUS AUREUS
Authors: P. F. Bartell, I. S. Thind, T. Orr, W. S. Blakemore
Journal: The Journal of Experimental Medicine (1963)

Staphylococcus bacteriophage 81 is capable of in vivo interaction with Staphylococcus aureus, Type 80/81. This is immediately made evident by increased levels of bacteriophage and concomitant survival of 81 per cent infected mice. The reaction is dependent upon the use of active, type-specific bacteriophage. The maximal protective effect is observed at a bacteriophage to bacteria ratio of 1:2 and decreased quantities of bacteriophage result in decreased protection. Time and sequence of administration are also determining factors. It is evident that bacteriophage administered intravenously is capable of interaction with the infecting bacterial cell at the site of infection. In vivo produced bacteriophage is apparently eliminated or otherwise rendered nondetectable fairly rapidly, occurring within a period of 5 to 10 days. However, it appears that host defense mechanisms are stimulated in the process and actively play a protective role against subsequent challenge inocula administered up to 3 weeks later.
Correlation of Milk Precipitins with IgA Deficiency
Authors: R. H. Buckley, S. C. Dees
Journal: New England Journal of Medicine (1969)

Undue susceptibility to infection is a feature of several diverse conditions in which precipitins to cow's milk are commonly found. To investigate the possible relation of the presence of milk precipitins to immunologic deficiency, we examined serum specimens of 138 patients with various immunologic defects. Highly significant (p less than 0.001) correlations were observed between a selective deficiency of serum IgA (when concentrations were 10 mg per 100 ml or less) and the presence of serum milk precipitins or milk tanned-cell hemagglutinating-antibody titers greater than 270. Precipitins were found in 18 of 24 IgA-deficient patients (75 per cent), in three of seven patients with Aldrich syndrome (43 per cent), but in only two of the remaining 107 immunologically deficient patients (1.9 per cent). It appears that such precipitating antibodies are more likely to develop when antibody production is impaired in the IgA class but intact in the other immunoglobulin classes.
Antibiotic resistance versus small molecules, the chemical evolution
Authors: Ving J. Lee, Scott J. Hecker
Journal: Medicinal Research Reviews (1999)

Two discovery approaches directed to addressing the problem of increasing bacterial resistance are described. The first is a program to build activity against methicillin-resistant Staphylococcus aureus (MRSA) into the cephalosporin class of antibacterials, by enhancing affinity for PBP2a, the penicilln-binding protein responsible for this resistance. Through stepwise improvement in potency, human serum binding, solubility, and betalactamase stability, a stable of new compunds with excellent potential as anti-MRSA agents was realized. From this set was chosen MC-02, 479 (RWJ-54428), which is now undergoing extensive preclinical evaluation. The second approach explores the uridyl peptide family of antibiotics, inhibitors of bacterial translocase (mraY), whose members include the pacidamycins, mureidomycins, and napsamycins. Access to a diverse set of analogs by total synthesis was catalyzed by the discovery that hydrogenation of the 4′-exoenamidofuranosyl moiety causes no loss in biological activity. Depthful exploration of SAR required (1) establishment of the absolute stereochemistry of the central diaminobutyric acid (DABA) moiety and (2) determination of the stereochemistry of the 4′-substituent on the deoxyfuranose unit. The former was accomplished by comparison of DABA derived from degradation of a natural product pacidamycin with a sample synthesized from L- threonine. The biological activity of one member of a synthesized library of possible stereoisomers of the natural product established the absolute stereochemistry of the remaining centers. A variety of analogs of the natural product were prepared utilizing the synthetic methods developed, and their biological activities provide important insights into the specificity and spectrum of the antibiotic class. © 1999 John Wiley & Sons, Inc. Med Res Rev, 19, No. 6, 521–542, 1999
Genetics of Osteoporosis
Authors: Stuart H. Ralston, André G. Uitterlinden
Journal: Endocrine Reviews (2010)

Osteoporosis is a common disease with a strong genetic component characterized by reduced bone mass, defects in the microarchitecture of bone tissue, and an increased risk of fragility fractures. Twin and family studies have shown high heritability of bone mineral density (BMD) and other determinants of fracture risk such as ultrasound properties of bone, skeletal geometry, and bone turnover. Osteoporotic fractures also have a heritable component, but this reduces with age as environmental factors such as risk of falling come into play. Susceptibility to osteoporosis is governed by many different genetic variants and their interaction with environmental factors such as diet and exercise. Notable successes in identification of genes that regulate BMD have come from the study of rare Mendelian bone diseases characterized by major abnormalities of bone mass where variants of large effect size are operative. Genome-wide association studies have also identified common genetic variants of small effect size that contribute to regulation of BMD and fracture risk in the general population. In many cases, the loci and genes identified by these studies had not previously been suspected to play a role in bone metabolism. Although there has been extensive progress in identifying the genes and loci that contribute to the regulation of BMD and fracture over the past 15 yr, most of the genetic variants that regulate these phenotypes remain to be discovered.
Cellular Viraemia in Babies Infected with Rubella Virus before Birth
Authors: I. Jack, J. Grutzner
Journal: BMJ (1969)

Chronic viraemia has been detected in 10 out of 12 rubella syndrome babies at periods ranging from 1 to 196 days. The virus was found to be associated with leucocytes, and it is assumed that removal of neutralizing antibody is the most likely explanation for the high success rate in detecting viraemia. The findings are discussed in relation to diagnosis by virus isolation, to pathogenesis, and to the possible significance in explaining the failure of the foetus to develop a tolerance to rubella virus. Several published reports of viraemia in the acute exanthematous disease are contrasted with the less frequent reports of viraemia in the chronic disease of early postnatal life.
Groups survey health care costs, charges
Authors: C. Marwick
Journal: JAMA (1991)

A SERIES of reports, just completed or in preparation, indicates strong agreement among government, medicine, and business leaders that the remaining years of the decade will see a continuing debate on the shortcomings of the nation's health care system. One report is coming by late summer from the 1991 Advisory Council on Social Security, another from the health subcommittee of the National Governors Association, and a third from the Department of Health and Human Services. Meanwhile, President Bush's Administration, in the person of its budget director, Richard G. Darman, has gone to Capitol Hill to warn that the rising costs of health care are "unsustainable." Spending on health has risen from less than 6% of the gross national product three decades ago to around 12% today, Darman says. He predicts that expenditures will reach 17% of the gross national product by the end of this century and 37% by the
The History of Psychiatry in Residency Training: Report of Survey II
Authors: WILLIAM F. KNOFF
Journal: American Journal of Psychiatry (1967)

Early in 1967, 100 teaching centers in the United States and Canada were surveyed by questionnaire in regard to their attitudes and practices in teaching the history of psychiatry. Eighty-seven responded. Many of the centers had been included in a similar study in 1961. Forty-four U. S. centers, and two Canadian, report that they are now offering courses in historical psychiatry—twice as many as in 1961. Average curriculum time is about 20 hours.
The Author Meets the Health-Care System
Authors: Daniel S. Greenberg
Journal: New England Journal of Medicine (1977)

Being concerned with high policy matters, my professional inquiries into medical affairs normally partake more of the long-distance observational technics of astronomy than of on-the-ground collection of data.The rationale for this is that it is easier to peruse and comment on the plethora of documents on the "health-care industry" than it is to go out there and see for oneself just what is going on in the great sprawl of American medicine.Now, the purpose of this self-effacement is to introduce an uncustomary venture into the anecdotal, which, by its very nature, is statistically irrelevant, worthless for policy-making or . . .
Tackling practice variation
Authors: F. Godlee
Journal: BMJ (2011)

Our enthusiasm for tackling the topic of practice variation has led us to commission five articles and a podcast. There’s an Analysis from “Jack” Wennberg, the undisputed father of practice variation, in which he deftly summarises the evidence of underuse, overuse, and misuse of health care in the US and the UK (doi:10.1136/bmj.d1513). There’s a commentary from Gert Westert and Marjan Faber from the Netherlands showing that variations are less extreme in what was, until recently, a centrally planned health system (doi:10.1136/bmj.d1429). We have a review by Chris Ham of Wennberg’s latest book (doi:10.1136/bmj.d1757), and a review of one of his earliest, the Dartmouth …
Cognitive behaviour therapy affects brain activity differently from antidepressants
Authors: S. Mayor
Journal: BMJ (2004)

Cognitive behaviour therapy triggers a different pattern of changes in brain activity than that triggered by the antidepressant paroxetine, according to a small pilot study that provides the first scan based evidence that the treatments work in different ways.

The researchers scanned 17 previously untreated patients with unipolar depression before and after a 15-20 session course of outpatient cognitive behaviour therapy. The group's mean score on the 17 item Hamilton depression rating scale, which rates …
Histochemical Studies of Human Coronary Atherogenesis: Comparison With Aortic And Cerebral Atherogenesis
Authors: F. T. Zugibe
Journal: Circulation Research (1963)

The literature contains many conflicting reports concerning the role of acid niucopolysaccharides and lipids in the pathogeneyis of coronary atherosclerosis.The most notable controversy concerns the earliest morphological alteration in atherogenesis.Some investigators hold that the accumulation of acid mucopolysaccharides is the reaction to a primary deposition of lipid, 1 while others hold that the converse is true.-' r S Previous studies of human aortas 4 and cerebral arteries' utilizing new histochemical methods indicated that no apparent relationship existed between acid mucopolysaccharides and Iipida with respect to staining intensity or distribution.The purpose of this paper is to report our observations on the relationships between lipid and acid mucopolysaccharides, lipid and elastic elements, and acid mucopolysaccharides and elastic and collagen elements in human coronary arteries from various age groups ranging from fetal life to seventy years of age and to compare these relationships with our previous observations in aortas and cerebral arteries. MethodsHuman coronary arteries were obtained fresh at autopsy from 175 individuals.These specimens included 27 arteries from fetuses, 30 arteries from individuals one day to seven years of age, 48 arteries from 8 to 16 years, and 70 arteries from 16 to 75 years.Individual lesions were grossly
Orally administered RDP58 reduces the severity of dextran sodium sulphate induced colitis
Authors: R Boismenu, Y Chen, K Chou, A El-Sheikh, R Buelow
Journal: Annals of the Rheumatic Diseases (2002)

Oral administration of the novel anti-inflammatory peptide RDP58 markedly reduced the severity of dextran sulphate sodium (DSS) colitis as determined by clinical and quantitative histological criteria. The architecture of the colonic epithelium in DSS treated mice receiving RDP58 remained relatively normal compared with that of control DSS treated animals. 5-Bromo-2′-deoxyuridine (BrdU) labelling studies showed a pronounced inhibition of colonic epithelial cell proliferation during DSS treatment, which was partially reversed by RDP58 therapy. Remarkably, RDP58 almost completely prevented colonic epithelial cell death induced by DSS treatment. RDP58 therapy also inhibited the accumulation of neutrophils in the colon of DSS treated mice and effectively down regulated tumour necrosis factor (TNF) expression. Preservation of the intestinal mucosa by RDP58 may thus derive from its influence on TNF expression as well as additional anti-inflammatory properties. These findings indicate that RDP58 represents a new, orally available agent potentially useful in the treatment of inflammatory bowel disease.
Measurement and perception of skin colour in a skin cancer survey
Authors: ADČLE GREEN, N.G. MARTIN
Journal: British Journal of Dermatology (1990)

A population-based prevalence survey of skin cancer was conducted in Nambour, Queensland, in 1986. The skin colour of 807 participants was assessed in three ways: quantitatively, graded by a dermatologist, and self-reported. Quantitation of skin pigmentation was obtained by measuring the reflectance of light of wavelength 650 nm, at six sites. Females showed higher mean reflectance (paler skin) than males at all sites with the greatest difference on the lateral forearms. Prevalent skin cancer in males, and solar keratoses in both sexes were correlated with inherently pale skin colour on an unexposed site, and the presence of keratoses was correlated with darkly-pigmented backs of the hands (P <0.001). Both dermatologists'and participants'grading of skin colour were moderately correlated with measured skin colour. For dermatologists, correlation was highest with reflectance from the medial upper arms (r= 0.35, right arm; 0.30, left) in males, and the lateral forearms (r= 0.34, right; 0.38, left) in females. Correlations between reflectance values and self-reported innate skin colour were highest for the upper arms (r= 0.26, right; 0.24, left) in males, and for forearms (r= 0.42, right and left) in females. Prevalence of actinic lesions was more highly correlated with subjectively assessed skin colour than with quantitative skin pigmentation.