tbuckley/cabot-search huggingface dataset:
To Have Been or Not to Have Been
Authors: Adolph Rostenberg
Journal: JAMA (1965)

<h3>To the Editor:—</h3> I read the editorial with interest. It states "... although one would not wish to hypothecate...." Unfortunately, the word "hypothecate" means to pledge or to pawn, and not to hypothesize, which is presumably the usage intended in the editorial. I suppose this illustrates the dangers inherent in casting stones. I had better read this letter carefully to make sure that I too do not become a target.
Tobacco companies aimed to keep smokers hooked, court told
Authors: Anne Harding
Journal: BMJ (2004)

Cigarette makers boosted nicotine levels and added ammonia to their product to make sure smokers became addicted, a former chief of the Food and Drug Administration, Dr David Kessler, testified in the District Court of Washington, DC, last Thursday.

Dr Kessler was the first witness in the federal government's $280bn (£155bn; €230bn) civil racketeering case against various tobacco companies. He described the industry's efforts to make cigarettes more effective as nicotine delivery devices, efforts that came to light in the FDA's 1994-5 investigation into whether cigarettes should be regulated as drugs.

According to Dr Kessler's written testimony, cigarette makers …
The FDA—A Misunderstood Agency
Authors: Joshua M. Sharfstein
Journal: JAMA (2011)

ANYONE WHO SPENDS A DAY AT THE US FOOD AND Drug Administration (FDA) will appreciate the scale of its responsibilities. Hundreds of drugs, devices, and biologics under review; thousands under surveillance. The safety of approximately fourfifths of the food supply. Nutrition labeling. Animal drugs. A new regulatory structure for tobacco products. And cosmetics too. Anyone who spends a week at the FDA will experience the agency’s many roles. For patients with severe illness and for their physicians, the FDA is the judge of whether promising ideas in the laboratory can make it to the bedside. For entrepreneurs, the agency is the gatekeeper that determines the viability of investments in innovative products. For consumers, the FDA is the last line of defense before an unsafe treatment or food threatens the public. Anyone who spends a month at the FDA will recognize the striking disconnect between the agency and its public image. Nearly all the attention focuses on the latest regulatory controversies. As a result, many see the FDA as little more than a factory for disputes. Few notice systematic movement below the surface. It is easy to craft a story about the FDA based on just a couple of actions, out of hundreds taken each year. So competing narratives abound. Some claim the FDA is captive to manufacturers and too quick to approve new therapies; others assert the agency is safety obsessed and too slow to make treatments available. Some criticize the FDA for refusing to challenge advertising claims; others fault the agency for restricting reasonable avenues of marketing that could inform the public. Sometimes stories outlining conflicting perspectives appear on facing pages of the same newspaper. Anyone who has spent approximately 2 years at the FDA, as I have, will wonder what it will take for the agency to be better understood. The FDA is a global organization staffed by thousands of physicians and other scientists who have deep knowledge in their fields and pursue their tasks with energy and sincerity. The FDA scientists regularly conduct laboratory studies and primary analyses of data before reaching conclusions. Actions of the FDA rest on a foundation of science, policy, and judgment. Under the leadership of FDA Commissioner Dr Margaret A. Hamburg, the agency has been strengthening this foundation.
An investigation into general practitioners associated with high patient mortality flagged up through the Shipman inquiry: retrospective analysis of routine data
Authors: Mohammed A Mohammed, Anthony Rathbone, Paulette Myers, Divya Patel, Helen Onions, Andrew Stevens
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b> To identify a credible explanation for the excessively high mortality associated with general practitioners who were flagged up by the Shipman inquiry. <b>Design</b> Retrospective analysis of routine data. <b>Setting</b> Primary care. <b>Participants</b> Two general practitioners in the West Midlands who were associated with an unacceptably high mortality of patients during 1993-2000. <b>Main outcome measures</b> Observed and expected number of deaths and deaths in nursing homes. <b>Results</b> Preliminary discussions with the general practitioners highlighted deaths in nursing homes as a possible explanatory factor. No relation was found between the expected number of deaths and deaths in nursing homes in each year during 1993-2000 for either general practitioner. In contrast, the magnitude and shape of the curves of a cumulative sum plot for excess number of deaths (observed minus expected) in each year were closely mirrored by the magnitude and shape of the curves of the number of patients dying in nursing homes; and this was reflected in the high correlations (R<sup>2</sup> = 0.87 and 0.89) between excess mortality and the number of deaths in nursing homes in each year for the general practitioners. These findings were supported by administrative data. <b>Conclusions</b> The excessively high mortality associated with two general practitioners was credibly explained by a nursing home effect. General practitioners associated with high patient mortality, albeit after sophisticated statistical analysis, should not be labelled as having poor performance but instead should be considered as a signal meriting scientific investigation.
Cerebral Vascular Diseases
Authors: Oscar Sugar
Journal: JAMA (1969)

The modest price of this book makes it worthwhile for anyone interested in "stroke." This holds even for the clinician who might not find much of immediate interest in the chapters on fluid dynamics, viscosity, platelet aggregation, and other facets of research in the fields of cerebral circulation and respiratory control. However, there are many pieces of information and interesting discussions of practical interest: identification of the stroke-prone patient; pathogenesis and medical treatment of intracerebral hemorrhage; reports of the joint cooperative studies on stroke, hypertension, and extracranial vascular occlusive disease; aids in diagnosis of cerebrovascular disease, the role of vascular disease in dementia; and effects of thromboendarterectomy in bilateral carotid occlusive disease. A new procedure for control of hypertension in humans—stimulalation of the carotid sinus nerve by implanted electrodes—is described; an old one—compression of the carotid artery and its sinus—is revived to help in evaluating cerebral-vascular collateral reserve. This transcript
Further Evaluation of Aortic Valve Homografts Sterilized by Electron-Beam Energy
Authors: FREDERICK O. BOWMAN, JAMES R. MALM, PAUL D. HARRIS, GERARD A. KAISER, ANTHONY T. KOVALIK
Journal: Circulation (1969)

Clinical results with the use of irradiated aortic valve homografts in 45 patients are reported. These valves have functioned satisfactorily up to 2 years. Forty-four per cent of the surviving patients developed a murmur suggestive of a degree of aortic valvular insufficiency. One required re-operation, and all others remain in excellent compensation. Emphasis is placed on the precise surgical technique of implantation and the proper selection of graft size, as well as the technique of preservation of the graft in obtaining a satisfactory hemodynamic result.
Surgical Diseases of the Chest
Authors: Alan T. Marty
Journal: JAMA (1975)

The contributors summarize the "amazing and gratifying advances" in thoracic and cardiac surgery. The major change in this edition, besides 493 more illustrations and 24 new authors, entails its greater emphasis on surgical technique. Excellent new sections on heart and lung transplantation, valve replacement, cardiac assist devices, pacemaking, and thoracic outlet syndrome have been added. The original material concerning empyema, lung abscess, bronchiectasis, and tuberculosis has also been retained and updated. Typical of the major overhaul that many chapters receive is that on the esophagus: the authors are different, illustrations have tripled, the bibliography doubled, and more space is devoted to surgical technique and judgment. Elsewhere, regarding mitral stenosis, "the fallacy of routine open operations" is thoroughly discussed in an effort to reverse the now prevalent "technical myopia" that ignores the option of closed mitral valvuloplasty in selected cases. The chapter on anesthesia contains a curious espousal of thiopental sodium
Characterisation of human articular cartilage link proteins from normal and osteoarthritic cartilage.
Authors: J Ryu, C A Towle, B V Treadwell
Journal: Annals of the Rheumatic Diseases (1982)

Proteoglycan link proteins were isolated from human articular cartilage obtained from normal and osteoarthritic femoral heads and purified to homogeneity employing a method previously described by this laboratory. The link proteins were analysed for amino acid composition, molecular weight on sodium dodecyl sulphate polyacrylamide gels, and ability to stabilise proteoglycan aggregates. The results of these studies were compared with those obtained with bovine link proteins. Two link proteins were identified in the purified fraction from normal and osteoarthritic human cartilage with apparent molecular weights of 54 000 (link 1) and 48 000 (link 2). Functionally the link proteins, isolated from osteoarthritic and normal cartilage, were indistinguishable as measured by their ability to stabilise aggregate. The amino acid compositions of normal and osteoarthritic link proteins were also found to be similar to each other but significantly different from the amino acid composition reported for the bovine link proteins. The quantities of these proteins in extracts from normal and diseased tissue were similar, as was the ratio of link protein 1 to link protein 2.
Number of deaths from cholera in Haiti nears 1000
Authors: J. Zarocostas
Journal: BMJ (2010)

The surge in the number of people with cholera in Haiti has stretched medical facilities on the island to the limit, leaving many facilities in urgent need of more personnel and equipment, say authorities and relief organisations. The World Health Organization warned last week that up to 200 000 people could contract cholera over the next six to 12 months.

The Haitian ministry of health said that, up to 12 November, nearly 15 000 people had been admitted to hospital for cholera and that 917 had died.

Stefano Zannini, head of mission in Haiti for …
Centralising acute stroke services: study confounded by financial investment
Authors: A. M. Hill
Journal: BMJ (2014)

Morris and colleagues did not discuss how substantial financial investment in services affected their results.1 The London stroke strategy was supported by an additional £23m (€28.8m; $37.3m) in funding.2 The cost improvement programme highlighted the need for an extra £13m investment in hyperacute stroke units to …
What's Wrong With Chemoprevention of Prostate Cancer?
Authors: Stewart Justman
Journal: The American Journal of Bioethics (2011)

When prostate-specific antigen (PSA) testing was introduced, proponents expected it to cut prostate-cancer mortality and did not expect it to unleash an epidemic of unnecessary treatments. Now that evidence of a mortality benefit remains unclear while evidence of overtreatment in undeniable, there is understandable interest in reducing the human costs of the PSA system. Two related drugs, finasteride and dutasteride, both proven to reduce the incidence of prostate cancer and the “risk of diagnosis,” are being promoted accordingly. However, if not for the flaws of the PSA system the use of these drugs for purposes of prevention would lose its rationale. Not only are the drugs in this sense dependent on a faulty system, but their own mortality benefits are as speculative as PSA's—in addition to which, they introduce new risks.
Infant Death Rates
Authors: Jan Schneider
Journal: JAMA (1971)

To the Editor. —  During the past few years a series of articles was published which intended to counter the indictment that the United States has an unacceptably high infant mortality. The arguments raised have included a mixture of contradiction and paranoia. At times the basic data from abroad have been rejected as untrue or invalid. At other times it has been noted that European countries do not have the same problem of communication, distances, diverse populations, and multiple social issues which beset the United States. The first argument denies that the problem exists, while the second makes excuses for it!  An editorial inThe Journal( 215 :1318, 1971) suggested that infant mortality is a poor indicator of the health of a nation. The article noted that infant deaths represented only 2.2% of mortality in the United States, while 70% of deaths were due to heart disease, cancer, or stroke.
Tissue factor expression in human arterial smooth muscle cells. TF is present in three cellular pools after growth factor stimulation.
Authors: A D Schecter, P L Giesen, O Taby, C L Rosenfield, M Rossikhina, B S Fyfe, D S Kohtz, J T Fallon, Y Nemerson, M B Taubman
Journal: Journal of Clinical Investigation (1997)

Tissue factor (TF) is a transmembrane glycoprotein that initiates the coagulation cascade. Because of the potential role of TF in mediating arterial thrombosis, we have examined its expression in human aortic and coronary artery smooth muscle cells (SMC). TF mRNA and protein were induced in SMC by a variety of growth agonists. Exposure to PDGF AA or BB for 30 min provided all of the necessary signals for induction of TF mRNA and protein. This result was consistent with nuclear runoff analyses, demonstrating that PDGF-induced TF transcription occurred within 30 min. A newly developed assay involving binding of digoxigenin-labeled FVIIa (DigVIIa) and digoxigenin-labeled Factor X (DigX) was used to localize cellular TF. By light and confocal microscopy, prominent TF staining was seen in the perinuclear cytoplasm beginning 2 h after agonist treatment and persisting for 10-12 h. Surface TF activity, measured on SMC monolayers under flow conditions, increased transiently, peaking 4-6 h after agonist stimulation and returning to baseline within 16 h. Peak surface TF activity was only approximately 20% of total TF activity measured in cell lysates. Surface TF-blocking experiments demonstrated that the remaining TF was found as encrypted surface TF, and also in an intracellular pool. The relatively short-lived surface expression of TF may be critical for limiting the thrombotic potential of intact SMC exposed to growth factor stimulation. In contrast, the encrypted surface and intracellular pools may provide a rich source of TF under conditions associated with SMC damage, such as during atherosclerotic plaque rupture or balloon arterial injury.
Community Health and Socioeconomic Issues Surrounding Concentrated Animal Feeding Operations
Authors: Kelley J. Donham, Steven Wing, David Osterberg, Jan L. Flora, Carol Hodne, Kendall M. Thu, Peter S. Thorne
Journal: Environmental Health Perspectives (2006)

A consensus of the Workgroup on Community and Socioeconomic Issues was that improving and sustaining healthy rural communities depends on integrating socioeconomic development and environmental protection. The workgroup agreed that the World Health Organization’s definition of health, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” applies to rural communities. These principles are embodied in the following main points agreed upon by this workgroup. Healthy rural communities ensure a) the physical and mental health of individuals, b) financial security for individuals and the greater community, c) social well-being, d ) social and environmental justice, and e) political equity and access. This workgroup evaluated impacts of the proliferation of concentrated animal feeding operations (CAFOs) on sustaining the health of rural communities. Recommended policy changes include a more stringent process for issuing permits for CAFOs, considering bonding for manure storage basins, limiting animal density per watershed, enhancing local control, and mandating environmental impact statements.
A Case of Persistent Ovarian Menorrhagia: Oophorectomy: Recovery
Authors: J. Meredith
Journal: BMJ (1879)

THE BRITISH MEDICAL 7OURNAL pseudo-menstruation which frequently follows ovarian operations, and this lasted for three days.On September i8th, she left the hospital quite well; and the house- surgeon's note is: "Patient bright and cheerful; memory quite re- turned; and she is able to reply intelligently to questions put to her.
HEREDITY OF DISEASE
Authors: C. B. DAVENPORT
Journal: JAMA (1926)

In discussing so extensive and somewhat vague a topic as heredity of disease it is necessary, first of all, to define terms. It is obvious, in view of the diversity of attitude of medical men toward heredity, that there is a corresponding diversity of connotations connected with the word. In the present article, I will use heredity as covering the internal factors that direct development. This is not to say that there are any internal factors which, alone of themselves, determine the course of development but that internal factors play a very important rôle, such that through them are determined the specific form and most of the details of development, given an adequate and appropriate environment in which the development can take place. The end-result of development is the reaction between the internal factors and the external factors. The internal factors may be called the genotype and the end-result may be spoken of as the phenotype.
Complication Rates as a Measure of Quality of Care
Authors: Jennifer Daley
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Dr Silber and colleagues<sup>1</sup>strongly recommend that complication rates in coronary artery bypass graft (CABG) surgery should not be used to judge hospital quality of care. We have serious concerns about the validity of this conclusion because of several limitations in their study. First, we question both the definitions and rates of complications noted in the study. Their conceptualization of postoperative complications for CABG surgery appears flawed. It is important to distinguish between complications that are common sequelae of patients' illness (eg, congestive heart failure) and those that are more likely to result from substandard care (eg, deep wound infection). Despite the authors' definition of a complication as "a finding not noted on admission, but present after the second hospital day or during or after surgery," clinical conditions present before CABG surgery (eg, hypotension, congestive heart failure, and cardiac emergency) that are preoperative risk factors could
Prevalence of vulval lichen planus in a cohort of women with oral lichen planus: an interdisciplinary study
Authors: P. Belfiore, O. Di Fede, D. Cabibi, G. Campisi, G.S. Amarù, S. De Cantis, E. Maresi
Journal: British Journal of Dermatology (2006)

Lichen planus (LP) is a mucocutaneous inflammatory dermatosis that frequently involves the oral and genital mucosae. Patients with LP affecting these sites are often seen by oral medicine specialists or gynaecologists who work in isolation and depend heavily on histopathologists to help them in confirming the diagnosis. There are few studies in the literature combining the experiences of these specialists who share the care of patients with both oral and genital LP.To estimate the prevalence of vulval LP (VLP) in a cohort of patients with histologically confirmed oral LP (OLP).The study group consisted of 42 women histologically diagnosed with OLP. The mean age was 60.5 years (range 27-81). They underwent genital examination, colposcopy and vulvoscopy. For the histological confirmation of clinical VLP biopsies were performed whenever a clinical lesion was found. Oral and genital biopsy specimens were processed through histological and immunohistochemical staining. Histological diagnoses of LP were made according to the modified World Health Organization histopathological criteria proposed by van der Meij and van der Waal for the diagnosis of OLP, and extended to VLP. Patients with clinical evidence, but without the histological confirmation of OLP and VLP, were excluded from the study group.Thirty-two vulval and one vaginal biopsy specimens were obtained. Histological diagnoses were confirmed in 24 of 32 (75%) patients who underwent a vulval biopsy: these represent 57% (24 of 42) of the study group. Of the 12 patients free of symptoms such as itching, burning and dyspareunia, but with clinical vulval lesions, 11 (92%) had histological confirmation of VLP. Vulval lichen sclerosus was ascertained in five of 32 (16%) cases.This study showed a 57% prevalence of VLP in selected patients with OLP. The high prevalence of VLP of 92% in the women who were free of vulval symptoms confirmed the usefulness of this careful integrated approach.
CONTRIBUTIONS OF THE MEDICAL PROFESSION TO GENERAL LITERATURE AND COLLATERAL SCIENCES.
Authors: GEORGE R. HIGHSMITH
Journal: JAMA (1900)

This is an age of progress, in which the genius and untiring labor of the philosopher, the scientific thinker and the patient investigator have laid broad and deep the foundations for a higher and happier civilization than the world has hitherto known. There has been an intellectual advancement, a moral uplifting, an ethical awakening, and a quickening of perception, which have led to the proper recognition of the duties and responsibilities of an enlightened citizenship. A broader and truer imperialism has been inaugurated; intellectual expansion has become a fixed policy of the entire profession, and the dream of happiness, through fraternity, freedom, justice and humanity seems to be realized. There never was a time in the history of the world when knowledge was so easily accessible, and so eagerly sought after by the entire profession. The plodding country practitioner, located at the cross-roads, is as near the "springs of Helicon,"
Salivary Insulin in Normal and Type I Diabetic Subjects
Authors: Jagoda Pasic, John C Pickup
Journal: Diabetes Care (1988)

We studied the relationship of salivary insulin to serum insulin concentrations in normal subjects and type I (insulin-dependent) diabetic patients to test the hypothesis that salivary insulin might be a simple measure of insulinemia in diabetes. In 8 nondiabetic subjects, salivary insulin levels increased after an oral glucose load but with a delay in peak concentrations of ∼45 min in comparison with serum insulin levels. There was a significant correlation (r = .810, P &amp;lt; .01) between mean serum insulin and the salivary insulin 30 min later. In 12 type I diabetic patients, day profiles of saliva and serum insulin were obtained during usual insulin treatment, diet, and physical activity. In serum, the mean (±SE) percentage of bound insulin was 58.8 ± 5.2%, and in saliva it was 45 ± 3.5%. The mean ratio of salivary to serum free insulin throughout the day cwas 1:1.6. Although there was a significant correlation (r = .913, P &amp;lt; .001) between mean serum free insulin for all patients and the corresponding mean free salivary insulin, several individual profiles showed marked discrepancies between the timing and magnitude of insulin changes in the two compartments. We would not, therefore, recommend salivary insulin concentrations as a reliable index of insulinemia in individuals with type I diabetes.