tbuckley/cabot-search huggingface dataset:
Children say they are not involved enough in their treatment
Authors: Chibuzo Odigwe
Journal: BMJ (2004)

Children and teenagers are unhappy with the lack of communication they get when they are treated in the NHS and think that they are not sufficiently involved with the decision making process, a new report says.

The report, which was published by the Commission for Health Improvement last week, says that many children and teenagers felt they had the right to participate in decisions about their treatment rather than being passive recipients of care.

It was compiled …
What has social injustice to do with medicine?
Authors: F. Godlee
Journal: BMJ (2010)

Will Michael Marmot’s crucial review of health inequalities in England meet the same fate as its predecessor by Douglas Black? Certainly, as our editorial by David Hunter and colleagues points out (doi:10.1136/bmj.c684), there are striking parallels in the timing. Published in 1980, the Black report had been commissioned by a Labour government, but it reported to a less than enthusiastic Conservative one. Hunter et al think the Marmot report will fare better. We must hope so, but can we as doctors do more than just hope?

What prompts me to ask is Jane Moore’s letter (doi:10.1136/bmj.c482). In what she rightly calls “the “contrived and fictionalised image” in Fildes’ …
An Enigma Wrapped in Swaddling Clothes: Congress and “Crib Death”
Authors: William J. Curran
Journal: New England Journal of Medicine (1972)

CONGRESS has just published the report on the first Congressional investigation in American history devoted to what is called "sudden-infant-death syndrome," commonly known among physicians as "crib death."1 The objective of the investigation was to determine what the federal government's medical research program was doing about this problem.The findings were not encouraging, to say the least. The federal medical research establishment in 1971 was supporting only one research project directly related to the field. In the past seven years only five such research efforts were supported, all small by any relative criteria. It was generally agreed that there are . . .
Modulation of CD4 <sup>+</sup> CD28 <sup>null</sup> T Lymphocytes by Tumor Necrosis Factor-α Blockade in Patients With Unstable Angina
Authors: Vittoria Rizzello, Giovanna Liuzzo, Salvatore Brugaletta, Antonio Rebuzzi, Luigi M. Biasucci, Filippo Crea
Journal: Circulation (2006)

Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory cytokine that favors the expansion of CD4(+)CD28null T cells, an aggressive and unusual proinflammatory lymphocyte subset frequently observed in patients with unstable angina (UA). The purpose of the present ex vivo study was to evaluate whether inflammation in patients with UA may be modulated by selective blockade of TNF-alpha.Peripheral blood samples were collected from 17 patients with UA (Braunwald's class IIIB). CD4(+)CD28null T cells were assessed by flow cytometry and expressed as a percentage of all CD4+ T cells after 24 hours of incubation of whole blood with and without increasing doses (0.1, 1, 10, and 100 microg/mL) of infliximab, an anti-TNF-alpha monoclonal antibody. In addition, CD28 expression was assessed and expressed as mean fluorescence intensity (geometric mean of the CD28 fluorescence value on all CD4+ T cells). CD4(+)CD28null T-cell percentage decreased from a median of 6.2% (range, 1.2% to 23.9%) to 4.9% (range, 1.1% to 21.9%), 4.5% (range, 1.1% to 21.6%), and 4.1% (range, 0.4% to 21.4%) after incubation with 1, 10, and 100 microg/mL of infliximab (P for trend=0.043). Analysis of CD28 mean fluorescence intensity showed that the expression of CD28 on cell surface significantly increased after incubation with increasing doses of infliximab (P for trend=0.03).The findings of this ex vivo study show that CD4(+)CD28null T-cell expansion in patients with UA may be reduced by selective TNF-alpha blockade. Further studies are warranted to evaluate the clinical benefit of CD4(+)CD28null T-cell modulation.
876. Development of Novel Angiogenic DNA Medicine Using a Genomic/cDNA Hybrid of Hepatocyte Growth Factor Gene
Authors: Woong Hahn, Dong-Sik Kim, Wook-Bum Pyun, Won-Sun Yoo, Sun-young Kim, Jong-Mook Kim
Journal: Molecular Therapy (2006)

Background Hepatocyte growth factor (HGF) has angiogenic and antifibrotic activity and two isoforms of HGF are naturally expressed by alternative splicing. Here, we developed genomic/cDNA hybrids of HGF gene, which can generate two isoforms of HGF simultaneously and efficiently. We examined therapeutic potential of this novel form of HGF gene both in rabbit ischemic limb disease model and rat ischemic heart disease model. Methods and results We generated a series of genomic/cDNA hybrids of HGF gene. Comparative analysis on RNA expression pattern and efficiency of these constructs showed that the hybrid called HGF-X7 could express two isoforms of HGF more efficiently than cDNA of HGF and other hybrids. Next we compared the therapeutic potential of HGF-X7 expression DNA VM202 with that of VEGF165 DNA. The number of collateral vessels, capillary density and blood flow were significantly increased in HGF-X7 group in rabbit model as compared with VEGF165 and control group. Furthermore, ejection fraction, viable heart muscle area and capillary density were also considerably increased in HGF-X7 group in rat model. These results provided the first demonstration that the transfer of genomic/cDNA hybrid of HGF gene could be a promising treatment modality in human cardiovascular disease.
Better liver lesion diagnosis with mangafodipir trisodium (MNDPDP)-enhanced mr liver imaging: A multicenter study comparing MR and biphasic spiral CT
Authors: M. Oudkerk, P. van Dijk, C.G. Torres, M. Konig, J. Grimm, B. Op de Beeck, J. Fernandez-Cuadrado, M. Roddie, B. Song
Journal: Journal of Hepatology (2000)
The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus
Authors: Christian Weyer, Clifton Bogardus, David M. Mott, Richard E. Pratley
Journal: Journal of Clinical Investigation (1999)

The pathogenesis of type 2 diabetes involves abnormalities in insulin action, insulin secretion, and endogenous glucose output (EGO). However, the sequence with which these abnormalities develop and their relative contributions to the deterioration in glucose tolerance remain unclear in the absence of a detailed longitudinal study. We measured insulin action, insulin secretion, and EGO longitudinally in 17 Pima Indians, in whom glucose tolerance deteriorated from normal (NGT) to impaired (IGT) to diabetic over 5.1 ± 1.4 years. Transition from NGT to IGT was associated with an increase in body weight, a decline in insulin-stimulated glucose disposal, and a decline in the acute insulin secretory response (AIR) to intravenous glucose, but no change in EGO. Progression from IGT to diabetes was accompanied by a further increase in body weight, further decreases in insulin-stimulated glucose disposal and AIR, and an increase in basal EGO. Thirty-one subjects who retained NGT over a similar period also gained weight, but their AIR increased with decreasing insulin-stimulated glucose disposal. Thus, defects in insulin secretion and insulin action occur early in the pathogenesis of diabetes. Intervention to prevent diabetes should target both abnormalities.
CD8+ cellular immunity mediates rAd5 vaccine protection against Ebola virus infection of nonhuman primates
Authors: Nancy J Sullivan, Lisa Hensley, Clement Asiedu, Thomas W Geisbert, Daphne Stanley, Joshua Johnson, Anna Honko, Gene Olinger, Michael Bailey, Joan B Geisbert, Keith A Reimann, Saran Bao, Srinivas Rao, Mario Roederer, Peter B Jahrling, Richard A Koup, Gary J Nabel
Journal: Nature Medicine (2011)
Synovitis of the Knee Joints in Late Congenital Syphilis
Authors: Luis Borella
Journal: JAMA (1962)

Attention is called to the fact that synovitis of the knee joints may occur in children between the ages of 8 and 15 years as a late manifestation of congenital syphilis. In this series of cases, signs of inflammation were a prominent feature and would have suggested other diagnoses had not the presence of congenital syphilis been established. In all cases the synovitis resolved spontaneously after several months and left no residual joint damage. Since the incidence of syphilis is increasing at present, it is important that the diagnosis of late congenital syphilis be kept in mind in considering any case of synovitis of the knees in children.
THE HAZARD OF SURGICAL ANESTHESIA WITH SYPHILIS OF THE BRAIN
Authors: E. R. LeCOUNT
Journal: JAMA (1925)

That syphilis bears an important relationship to the work of surgeons has been recognized for many years. As early as the sixteenth (Anatus Lusitanus1) and seventeenth (Saviard1) centuries it was pointed out that in patients with syphilis, wounds healed much more slowly than similar lesions in healthy persons. Subsequent similar experiences of other writers have led to the general acceptance of this time-honored observation, so that at present the local effects of active syphilis are well known.  Aside from its influence on the healing of wounds, syphilis offers to the surgeon an entirely different concern in respect to its general or constitutional effects on the patient. Death in syphilitic subjects following relative minor surgical procedures has occurred in all likelihood in the practice of many surgeons, although reports of such fatalities are exceedingly few. Treves2attributes the loss of life in this type of case not to
Indium-111 Capromab Pendetide (ProstaScint) Images Before and After Salvage Radiation Therapy
Authors: JAMES S. WELSH, MARIE H. YANEZ, BENNETT B. CHIN, STEVEN P. HOWARD
Journal: Clinical Nuclear Medicine (1999)

A 50-year-old man diagnosed with early-stage prostate cancer underwent a radical prostatectomy in 1992. His prostate-specific antigen (PSA) decreased to an undetectable level after operation, but 5 years later it had increased to 0.3 ng/ml. Results of a physical examination and bone scan were unremarkable. The time course of the postoperative PSA increase was suggestive of local recurrence. A ProstaScint scan from March 1997 showed abnormal activity only in the prostatic fossa, consistent with local recurrence. He underwent salvage radiation therapy to the prostate bed, which ended in June 1997. His serum PSA returned to undetectable levels and he has since remained clinically disease free. A repeated ProstaScint scan from July 1998 revealed no evidence of disease.
Management of Antimicrobials in Infectious Diseases: Impact of Antibiotic Resistance
Authors: Nelson M. Gantz
Journal: Annals of Internal Medicine (2001)

Medical Writings: Book Notes17 July 2001Management of Antimicrobials in Infectious Diseases: Impact of Antibiotic ResistanceNelson M. Gantz, MDNelson M. Gantz, MDPinnacle Health System, Harrisburg, Pennsylvania. (Gantz)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-2-200107170-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Mainous AG 3rd, Pomeroy C, eds. 368 pages. Totowa, NJ: Humana Pr; 2001. $99.50. ISBN 0896038211. Order phone 973-256-1699.Field of medicine: Infectious diseases.Format: Hardcover book.Audience: Physician assistants, nurse practitioners, generalists, and infectious disease specialists.Purpose: To help clinicians manage common infectious diseases by using an evidence-based approach to antibiotic selection.Content: The first of 19 chapters discusses antibiotic resistance. Six chapters cover various etiologic agents, and 11 chapters focus on selected infectious disease problems. The final chapter discusses future trends in antimicrobial use and resistance.Highlights: The book provides a concise review of selected topics in the ... Author, Article, and Disclosure InformationAffiliations: Pinnacle Health System, Harrisburg, Pennsylvania. (Gantz) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 July 2001Volume 135, Issue 2Page: 144KeywordsAntibiotic resistanceAntibioticsAntimicrobialsInfectious diseasesNursesRocky Mountain spotted feverSoftware toolsToxic shock syndromeVaccines ePublished: 17 July 2001 Issue Published: 17 July 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
New Zealand GPs call for end to direct to consumer advertising
Authors: Z. Kmietowicz
Journal: BMJ (2003)

GPs in New Zealand are petitioning the health minister to ban the advertising of prescription drugs to patients. New Zealand is one of only two countries that allow drug companies to advertise directly to the public; the other is the United States.

But GPs in New Zealand say that such advertising causes many problems that are bad for doctors, the economy, and patients. They have estimated that it cost the country $NZ2.7m (£0.94m; $1.56m; ‡1.3m) between …
Points from Letters: G.M.C. Retention Fee
Authors: D. T. C. Barlow
Journal: BMJ (1970)

refers I did not comment directly on the case for or against a large increase in number, but was concerned with the evi- dence indicating that the Royal Commission had failed to understand the mathematical basis on which they proposed an exponential expansion, and had thus reached a wholly unjustifiable conclusion about the number of doctors necessary.I also drew attention to the implications of an error of this magnitude, which could require perhaps the provision of 10,000 unnecessary doctors in 10 years, a number equivalent to the output of five new medical schools.As this appears a serious matter, one would expect the mathematical errors in this section of the report to have been ac- knowledged and corrected before now, since it must surely be necessary to prepare a new estimate based on less indefensible grounds.If, however, my conclusions are unjustified, it should be an easy matter to refute them.-Iam, etc.,
New Zealand's regulation of new psychoactive substances
Authors: J. Newberry, A. Wodak, D. Sellman, G. Robinson
Journal: BMJ (2014)

A response to the futility of trying to ban such substances as they appear

Last year the New Zealand parliament passed the Psychoactive Substances Bill 2013, which the associate minister for health argued was “to protect New Zealanders, particularly young New Zealanders, from the harm caused by untested drugs and an unregulated market.”1 2 This started the process of creating a controlled market in recreational drugs, which is a major shift away from the approach taken for many decades by almost all countries of prohibiting about 250 specified psychoactive drugs. The act does not alter the existing restrictions on controlled drugs but sets up a framework for regulating the market for some new drugs.

The impetus for this legislation was the increasing availability of new substances, particularly γ-hydroxybutyrate (GHB, “fantasy”), benzylpiperazine (BZP), and a range of synthetic cannabinoids.

Other countries have also become increasingly worried about the growing number of new psychoactive drugs. The European Police Office reports that the number of newly identified drugs in the European Union continues to increase, with 24 reported in 2009, 41 in 2010, 49 in 2011, and 73 in 2012.3 The growing problem of emerging synthetic drugs was also recognised in 2013 in the United States.4

Like most other countries, New Zealand’s previous laws on psychoactive drugs with addictive …
Hyperhomocysteinemia and the MTHFR C677T mutation in Budd‐Chiari syndrome
Authors: Xiao‐Mei Li, Ying‐Fei Wei, Hong‐Ling Hao, Yu‐Bin Hao, Li‐Shan He, Jing‐Dong Li, Bing Mei, Su‐Yun Wang, Chao Wang, Jun‐Xiang Wang, Jun‐Zhen Zhu, Jin‐Quan Liang
Journal: American Journal of Hematology (2002)

Abstract Hyperhomocysteinemia (HH) is a factor that predisposes individuals to thrombosis, and the C677T mutation in the 5,10‐methylenetetrahydrofolate reductase (MTHFR) is known to give increased plasma homocysteine. However, little is known about their roles in Budd‐Chiari syndrome (BCS). This study evaluated the roles of HH and the MTHFR C677T mutation in patients with BCS. We compared 41 BCS patients with 80 sex‐ and age‐matched healthy controls. The mean plasma homocysteine level was significantly higher in patients with BCS (20.15 ± 5.78 μmol/L) compared with normal controls (15.80 ± 6.58 μmol/L), P &lt; 0.01. HH (&gt;19.5 μmol/L in men and &gt;15.0 μmol/L in women) was detected in 15 (36.59%) patients and in 14 (17.5%) controls (odds ratio [OR], 2.72; 95% confidence internal [CI], 1.17–6.32). The prevalence of the mutated MTHFR 677TT genotype and the 677T allele in normal controls was 10.0% and 31.3%, respectively. The mutant 677T homozygotes and alleles were more frequent in patients with BCS than in controls (22.0% vs. 10.0%, 0.025 &lt; P &lt; 0.05; 45.1% vs. 31.3%, 0.025 &lt; P &lt; 0.05). The relative risk of BCS among the carriers of 677TT was significantly increased (OR, 3.3; 95% CI, 1.1–10.0). The mutant MTHFR heterozygous 677C/T carriers were not significantly increased in patients with BCS compared with controls (46.3% vs. &lt; 2.5%, P &gt; 0.05). The relative risk OR of BCS among carriers of 677C/T was 1.6 (95% CI, 0.7–3.6). This study suggests that both HH and the homozygous C677T mutation in the MTHFR gene are important risk factors of BCS. Am. J. Hematol. 71:11–14, 2002. © 2002 Wiley‐Liss, Inc.
Effects and Limitations of Cognitive Behavior Therapy in Bulimia Inpatients
Authors: Sabine Bossert, Edeltrud Schnabel, Jürgen-Christian Krieg
Journal: Psychotherapy and Psychosomatics (1989)

Cognitive behavior therapy was applied to 8 inpatients with bulimia (DSM-III). Improvement of bulimia was superior when compared to 6 bulimics treated with nonspecific psychotherapy. Social maladjustment was linked to the maintenance of bulimia. The effectiveness of cognitive behavior therapy seemed to be impaired by co-morbidity and dysphoric mood. Therefore a more structured externally controlled behavioral hospital treatment program is recommended.
Verbal Medical Orders
Authors: David W. Kinnaird
Journal: JAMA (1972)

<h3>To the Editor.—</h3> One of the most vexing, time-consuming problems confronting the practicing clinical physician is the necessity to sign each verbal medical order for a hospital patient. In so much as these orders are signed days or weeks after their execution, it is difficult to understand the medical benefits of such a requirement. The answer to any inquiry about the signing of verbal orders has always been that it is legally essential for a complete medical document. I have often wondered what the precedent is for this rejoinder. Likewise, it would seem that the signing of the face or summary sheet of the record would attest to one's approval of the complete record. The 1970 edition of the<i>Accreditation Manual for Hospitals</i>skirts the whole problem and only makes reference to the signing of telephone orders within 24 hours. Based on my knowledge of the hospital practice of a
Surgical Observations and Reflections
Authors: J. Sloane
Journal: BMJ (1857)

was much disturbed.At the left apex tho first sound was still somewhat obscure, blut the second was lotidly reduplicate with- out a trace of murmur: the phenomenon had persisted some considerable time.In a second case, the patient, a young woman, was evidently ,phthisical; slhe had recently suffered from violent hnmoptysis:..at the base, the second sounds were loudly anid distinctly re- duplicate; while, at the apex, the second sound was heard clear, single, and defined.The last case I have to mention, and which has been ex- .aminedby many competent observers, is so unusual, that I think it right to state it in detail.CASE.Alfred Adams, aged 24, a coppersmith by trade, of ,middle stature, slightly built, of dark brown skin and florid -lips, had an attack of huemoptvsis five or six years ago.A se- cond attack occurred eight months ago; he thinks a quart of -blood was expectorated altogether in this last attack.It occurred at night, and was preceded by cough.Present symitptoms.He has dyspncea; cardiac and epigastric pain, of burning character on exertion; pain in the arms; palpitation, whiclh has existed for some years; cough, with slight yellow expectorationi; great nervousness; morning, sickness; he sleeps in the horizontal posture; he has never had rheumatic fever.There is no evidence of renal disease.Inspection.The chest is symmetrical; the left nipple slightly highest; there is no marked arterial impulse or venous disten.sion.The heart's impulse is observed at, and two inches to the left of the left nipple; it is slight in epigastrio; respiration is tranquil during a state of repose.Palpation.The cardiac impulse is considerably increased (systolic and diastolic); there is heaving, fine diastolic fre- .mitus; the apex of the heart is felt two inches to the left of the left nipple.The pulse is of the same character in both Wrists, exceedingly irregular and unequal, a few slow, followed -by very rapid beats.Percussion.The area of cardiac impulse is increased both to the left and the right side, corresponding to the visible and Selt impulse.Auscultation.The impulse is slightly heaving; the first sound of crumpling and rasping character at the base (right ,and left), the apex, and round the axilla; it is less marked in .carotids.The second sound repeats itself four times dis-An analysis of cases of amputation in the Radcliffe Infirmary, Oxford, drawn up by Mr.