tbuckley/cabot-search huggingface dataset:
TCT-565 OCT evaluation of the time course of vessel healing following implantation of new generation biodegradable polymer-coated and sirolimus-eluting cobalt-chromium coronary stent system (ALEX OCT Study).
Authors: Jacek Legutko, Robert J. Gil, Pawel E. Buszman, Greg L. Kaluza, Marek Krol, Roman Wojdyla, Tomasz Pawlowski, Michał Brzeziński, Marek Kondys, Bartosz Skwarna, Jacek Jakala, Tomasz Roleder, Wojciech Zasada, Dariusz Dudek
Journal: Journal of the American College of Cardiology (2013)
Elephants and scapegoats in the pressures on emergency departments
Authors: R. J. Clearkin
Journal: BMJ (2015)

Curiously, elephants in small rooms often escape detection even by experts. Ham’s editorial reviewed pressures on English emergency departments.1 2 Yet he avoided explaining that while the NHS runs at white heat, hospital bed numbers are still being cut. This is despite the UK having the second lowest per capita ratio in the European Union,3 the population having risen by 10%, and …
Relief of Symptoms
Authors: Stewart Wolf
Journal: JAMA (1962)

This has been a popular book. It covers the field of symptomatology in a remarkably complete way in 32 short chapters. The style is informal, almost chatty, but engaging. Symptoms are looked at broadly in terms of their significance to the patient as well as their intensity. Treatment is by no means confined to a recital of drugs. There is a good deal about general measures to relieve suffering, and considerable fatherly advice from the vast experience of the author. The bibliography is up-to-date but includes basic references as well. The book is well turned out, in clear print, on a double-column page. All in all, this is a sane and thoughtful, although sometimes discursive, consideration of symptoms of all sorts. The book should be useful for reference as well as for reading.
Mediastinal Lymphadenopathy in Infectious Mononucleosis
Authors: Talma Rosenthal
Journal: JAMA (1975)

ENLARGEMENT of lymph nodes in the neck almost invariably forms an integral part of the clinical features of infectious mononucleosis. When the lymphadenopathy is accompanied by sore throat and splenomegaly, the diagnosis of infectious mononucleosis is quite likely, but must be confirmed by specific laboratory examinations. The fact that<i>mediastinal lymph nodes</i>can be involved in this disease may be overlooked by the internist, since many patients with infectious mononucleosis do not have chest xray films taken. This article describes two patients with proved mononucleosis in whom marked mediastinal lymphadenopathy developed during the course of their disease. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 20-year-old soldier was admitted with sore throat, cough, and abdominal pain. Physical examination disclosed bilaterally enlarged cervical glands and mild hepatosplenomegaly. Laboratory data included a white blood cell count of 14,300/cu mm with 71% lymphocytes, most of them atypical. A chest x-ray film showed widening of the
Thymus-dependent (T) lymphocyte deficiency in progressive systemic sclerosis
Authors: P. HUGHES, SHIRLEY HOLT, N.R. ROWELL, JANIS DODD
Journal: British Journal of Dermatology (1976)

Circulating thymus-dependent (T) lymphocytes were estimated in twenty-seven patients with progressive systemic sclerosis (PSS) and in forty-five normal controls using the property of T lymphocytes to form rosettes with sheep red blood cells. The patients with PSS were found to have a reduction of T lymphocytes which correlated with the extent of visceral involvement by the disease, those with the lowest counts having the most extensive disease. These findings support the suggestion that immunological factors may be involved in the pathogenesis of PSS.
Dear Bioethics, The Country Needs You
Authors: Samual A. Garner
Journal: The American Journal of Bioethics (2007)

"Dear Bioethics, The Country Needs You." The American Journal of Bioethics, 7(10), pp. 38–39 Acknowledgement I would like to thank the Yale Bioethics Center for fostering a supportive academic environment and also thank Elisabeth Lingo and Derek Turner for reading a draft of this commentary.
Axial Bone Mass in Older Women
Authors: Eric S. Orwoll, Douglas C. Bauer, Thomas M. Vogt, Kathleen M. Fox
Journal: Annals of Internal Medicine (1996)

Objective: To determine the anthropometric, historical, and lifestyle factors associated with bone mineral density (BMD) of the spine and proximal femur in older women. Design: Cross-sectional analyses. Setting: Four clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela Valley, Pennsylvania. Participants: 7963 ambulatory, nonblack women 65 years of age or older. Measurements: Medical history was obtained by questionnaire and interview, and physical and anthropometric data were obtained by examination. Lumbar spine and proximal femoral BMDs were measured using dual-energy x-ray absorptiometry. Results: The multivariable models could predict 21% and 25% of the difference between participants in BMD at the femoral neck and lumbar spine, respectively. Weight was most highly associated with BMD. Postmenopausal estrogen use and other indicators of total estrogen exposure were strongly associated with increased BMD. Use of diuretics (both thiazide and nonthiazide), activity levels and muscle strength, alcohol intake, and dietary calcium intake were associated with higher BMD. A family history of osteoporotic fracture was strongly associated with low BMD. European ancestry and blond hair, childbirth or breast feeding, a history of hyperthyroidism, and progestin use were not associated with axial BMD. Conclusions: Weight is strongly associated with BMD. Estrogen exposure, physical activity, and calcium intake are also positively associated with BMD, whereas a family history of osteoporosis is associated with reduced BMD. These associations suggest ways to better identify risk for fracture. *For members of the Study of Osteoporotic Fractures Research Group, see the Appendix.
ABC of major trauma. Management of the upper airway.
Authors: D Watson
Journal: BMJ (1990)

First vital minutesAll severely injured patients have hypoxaemia in varying degrees.As soon as medical help arrives the first priority must be to ensure that the patient's airway is free and ventilation is unimpaired.Immediate administration of Indications for securing an airway supplementary oxygen to the unobstructed airway is of paramount with an endotracheal tube importance.Remember that in the first vital minutes the cervical spine of * Apnoea any patient with trauma should be considered broken until proved * Obstruction of upper airway otherwise.The neck must be kept stabilised without traction (for example * Protection of lower airway from soiling by using a spine board, sand bags, or a hard collar) at all times until the with blood or vomitus possibility of neck injury is excluded.* Respiratory insufficiency * Impending or potential compromise of In an unconscious patient any obstruction to the airway must be removed airway (prophylactic intubation)-for under direct vision.The laryngeal and pharyngeal reflexes should then be example, after facial burns or continuous assessed and respiratory performance examined.If protective reflexes are seizures after Intravenous diazepam .aisd.intracrnips reqin adequate-for example, the patient is coughing-retracting the tongue hyperventilation foward by employing the chin lift or jaw thrust manoeuvre or inserting an
Liver Transplantation for Budd-Chiari Syndrome
Authors: Charles W. Putnam
Journal: JAMA (1976)

Orthotopic liver transplantation was accomplished in a 22-year-old woman dying of the Budd-Chiari syndrome. She is well and has normal liver function 16 months postoperatively. In view of the good early result, it will be appropriate to consider liver replacement for this disease in further well-selected cases. (<i>JAMA</i>236:1142-1143, 1976)
The Bradshaw Lecture on the Correction of Certain Deformities by Operative Measures upon Bones: Delivered before the Royal College of Surgeons of England on December 8th, 1897
Authors: A. Willett
Journal: BMJ (1897)

To Mr. William Adams, of orthoptedic surgery fame, must be -ascribed the distinction of first placing before the profession -certainly in this country-a definite and carefully-matured plan for correcting faulty position in cases of synostosis at a joint; in the case in point it was the hip-joint, for which he proposed to saw through neck of the femur.Mr. Adams ,called his operationwhich, by the way, was performed for the first time on December ist, I869-subcutaneous osteo- tomy, since he operated upon the lines of subcutaneous tenotomy, making an incision only just large enough to admit of the introduction of a fine saw he had devised; then saw'ing in great part through the neck of the femur, and finally wrenching forcibly, he in this way fractured the bone.He instantly closed the wound, and all through the operation carefully excluded the entrance of air.I witnessed one of Mr. Adams's earlier operations, and well I remember how -immediately and completely the deformity wis removed.I was much impressed by the preision of the whole procedure.Adams's operation was introduced before the days of anti- septic surgery, and although in his cases I believesuppura- ---,! -,
Toll-like receptor 4 variants reduce airway response in human subjects at high endotoxin levels in a swine facility
Authors: Ambikaipakan Senthilselvan, James A. Dosman, Liliane Chénard, Lauranell H. Burch, Bernardo Z. Predicala, Randine Sorowski, David Schneberger, Tom Hurst, Shelley Kirychuk, Volker Gerdts, Yvon Cormier, Donna C. Rennie, David A. Schwartz
Journal: Journal of Allergy and Clinical Immunology (2009)
Systematic Review: Prediction of Perioperative Cardiac Complications and Mortality by the Revised Cardiac Risk Index
Authors: Meredith K. Ford
Journal: Annals of Internal Medicine (2010)

Background: The Revised Cardiac Risk Index (RCRI) is widely used to predict perioperative cardiac complications. Purpose: To evaluate the ability of the RCRI to predict cardiac complications and death after noncardiac surgery. Data Sources: MEDLINE, EMBASE, and ISI Web of Science (1966 to 31 December 2008). Study Selection: Cohort studies that reported the association of the RCRI with major cardiac complications (cardiac death, myocardial infarction, and nonfatal cardiac arrest) or death in the hospital or within 30 days of surgery. Data Extraction: Two reviewers independently extracted study characteristics, documented outcome data, and evaluated study quality. Data Synthesis: Of 24 studies (792 740 patients), 18 reported cardiac complications; 6 of the 18 studies were prospective and had uniform outcome surveillance and blinded outcome adjudication. The RCRI discriminated moderately well between patients at low versus high risk for cardiac events after mixed noncardiac surgery (area under the receiver-operating characteristic curve [AUC], 0.75 [95% CI, 0.72 to 0.79]); sensitivity, 0.65 [CI, 0.46 to 0.81]; specificity, 0.76 [CI, 0.58 to 0.88]; positive likelihood ratio, 2.78 [CI, 1.74 to 4.45]; negative likelihood ratio, 0.45 [CI, 0.31 to 0.67]). Prediction of cardiac events after vascular noncardiac surgery was less accurate (AUC, 0.64 [CI, 0.61 to 0.66]; sensitivity, 0.70 [CI, 0.53 to 0.82]; specificity, 0.55 [CI, 0.45 to 0.66]; positive likelihood ratio, 1.56 [CI, 1.42 to 1.73]; negative likelihood ratio, 0.55 [CI, 0.40 to 0.76]). Six studies reported death, with a median AUC of 0.62 (range, 0.54 to 0.78). A pooled AUC for predicting death could not be calculated because of very high heterogeneity (I 2 = 95%). Limitation: Studies generally were of low methodological quality, had varied definitions of cardiac events, and were statistically and clinically heterogeneous. Conclusion: The RCRI discriminated moderately well between patients at low versus high risk for cardiac events after mixed noncardiac surgery. It did not perform well at predicting cardiac events after vascular noncardiac surgery or at predicting death. High-quality research is needed in this area of perioperative medicine. Primary Funding Source: None.
Questions Raised About Measles Vaccine Trial
Authors: Charles Marwick
Journal: JAMA (1996)

FAILURE to fully explain the risks involved in a vaccine trial has undermined a well-intentioned effort to improve the immunogenic response to measles immunization in children younger than 12 years. In addition, because the participants in the study were primarily from minority groups, the episode carries racial and ethnic overtones. The trial, which was conducted under a contract with the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente of Southern California, started enrollment in May 1990. It compared a high-titer measles vaccine known as the Edmonston-Zagreb (EZ) strain with the measles vaccine currrently licensed in the United States, the Moraten strain. The objective was to determine if the high-titer vaccine would induce sufficiently protective levels of immunity in children younger than 1 year. The Moraten vaccine has reduced efficacy in inducing protective antibody in children that age. <h3>Subject of Recent Discussion</h3> The circumstances of the trial and the
Reconfiguring health systems
Authors: A. Black
Journal: BMJ (2002)

Many doctors and other health professionals are engaged in discussions about reconfiguring health services, and in particular building new hospitals. Here Andy Black, a former NHS hospital chief executive, argues that in England at least discussions about reconfiguring health services are too dominated by discussions about buildings. We lack a vocabulary to discuss other ways of investing in health gain. Perhaps surprisingly, the problems of labour supply may stimulate the radical change that is needed 

At a seminar on “the hospital of the future” earlier this year, the Department of Health estimated that 75% of English hospitals were involved in some form of reconfiguration debate—that is, discussions about where and how secondary and tertiary services should be provided. The Royal College Physicians claims that 61 English hospitals are isolated, provide only acute medical services, and should therefore be “reconfigured.”1 Many English readers of this journal will be involved in these discussions. These discussions should also be familiar to health professionals worldwide—though the precise balance of problems and opportunities that I discuss here will differ from place to place.

#### Summary points

Discussions about reconfiguring specialist health services are dominated by ideas of centralising services in big hospitals—yet the public persists in valuing local services

Investment in hospitals is well understood and professionals have good arguments for specialisation and centralisation

The NHS has no mechanisms for encouraging or assessing different sorts of investment for health gain

Labour supply problems and the promise offered by information technology may both force and enable future reconfigurations of services that genuinely improve health

Health systems must balance two purposes. In the short term they must respond to the demands of the population for access to existing services. At the same time they must try to improve the health of the whole population: get the waiting list down …
A differing pattern of association between dietary fish and allergen‐specific subgroups of atopy
Authors: K. Andreasyan, A.‐L. Ponsonby, T. Dwyer, A. Kemp, K. Dear, J. Cochrane, A. Carmichael
Journal: Allergy (2005)

Background: We examined the role of fish intake in the development of atopic disease with particular reference to the possibility of differential effects on allergen‐specific subgroups of sensitization. Methods: The exposure of interest was parental report of fish intake by children aged 8 years at the 1997 Childhood Allergy and Respiratory Health Study ( n = 499). The outcomes of interest were subgroups of atopy: house dust mite (HDM)‐pure sensitization [a positive skin‐prick test (SPT) ≥2 mm to Der p or Der f only], ryegrass‐pure sensitization (a positive SPT ≥2 mm to ryegrass only); asthma and hay fever by allergen‐specific sensitization. Results: A significant association between fish intake and ryegrass‐pure [adjusted odds ratio (AOR) 0.37 (0.15–0.90)] but not HDM‐pure sensitization [AOR 0.87 (0.36–2.13)] was found. Fish consumption significantly decreased the risk for ryegrass‐pure sensitization in comparison with HDM‐pure sensitization [AOR 0.20 (0.05–0.79)]. Conclusions: We have demonstrated a differential effect of fish intake for sensitization to different aeroallergens. This may be due to the different timing of allergen exposure during early life. Further investigation of the causes of atopic disease should take into account allergen‐specific subgroups.
A complicated case of diarrhoea
Authors: S. Vandermolen, K. Ewins, S. Perera, J. Wright, F. Huwez
Journal: BMJ (2014)

An 82 year old man presented with a six day history of watery diarrhoea, vomiting, abdominal cramps, and confusion. He had a history of hypertension, gout, and prostate cancer, which was well controlled on hormonal therapy. He was independent and lived alone. He had not travelled or used antibiotics within the past two months. On examination he appeared dehydrated, but was haemodynamically stable and afebrile. His abdomen was soft and non-tender, with normal bowel sounds. He had some erythema around the anus. The rectum was empty on digital examination. Initial investigations showed a raised C reactive protein (178 mg/L, reference range 0-8; 1 mg/dL=9.52 nmol/L) and acute kidney injury (creatinine 125 µmol/L, 60-130; 1 µmol/L=0.01 mg/dL; urea 16.6 mmol/L, 2.3-6.7; 1 mmol/L=2.8 mg/dL). He was also noted to be hypokalaemic (potassium 3.0 mmol/L, 3.5-5.3). A plain abdominal radiograph was normal. Stool was negative for Clostridium difficile toxin but stool culture grew Campylobacter jejuni . He was managed supportively with fluid resuscitation and received oral erythromycin 250 mg four times daily for five days. Diarrhoea became less frequent, but he remained unwell with persistent abdominal pain, persistently raised inflammatory markers, and renal dysfunction. He developed a palpable mass in the left iliac fossa. Abdominal computed tomography (figure⇓) showed numerous outpouchings of the colon (arrow 1), with fatty stranding (arrow 2), which suggested acute inflammation. An irregular fluid collection containing an air bubble was also seen along the sigmoid descending junction (arrow 3). Abdominal computed tomogram showing numerous outpouchings of the colon (arrow 1), with fatty stranding (arrow 2), and an irregular fluid collection containing an air bubble along the sigmoid descending junction (arrow 3)
Spoon feeding in postgraduate training?
Authors: M. Curtis
Journal: BMJ (1980)

Our trial has shown (after 200 patients) a decrease in infarct size (approximately one- third) and a reduction in the numbers developing complete infarction in those patients given intravenous beta-blockers within 12 hours of the onset of pain.'The treated group needed less diuretics both in hospital and on discharge, suggesting clinical as well as biochemical and electrophysiological benefit.It is important, as Professor Rose points out, not to dismiss (with small trials) therapy which might reduce morbidity and perhaps mortality by, say, 20% as being clinically insignificant in this common condition.
EXISTENCE OF A HITHERTO UNKNOWN DIETARY FACTOR ESSENTIAL FOR REPRODUCTION
Authors: HERBERT M. EVANS
Journal: JAMA (1923)

If female rats are reared on the now well known "synthetic" nutritive regimen consisting of fat, carbohydrate and protein in relatively pure, separate form, to which are added an appropriate salt mixture and daily doses of the vitamins A and B, normal growth and every appearance of health results. The animals are of splendid size, sleek coated and active. Depending somewhat on the season of the year, either a large proportion or, indeed, practically all of such animals are sterile. We have employed a basic ration of casein (18), cornstarch (54) and lard (15), following Osborne and Mendel, to which milk fat (9) and salts 1 (4) are added, the animals receiving separately and daily from 0.4 to 0.6 gm. of dried whole yeast (Harris). The sterility produced is a dietary deficiency disease, and can be quickly cured by a change of dietary regimen. It yields a highly characteristic picture,
Dermatologic Disorders Diminish Quality of Life
Authors: Lynne Lamberg
Journal: JAMA (1997)

WHEN PATIENTS with severe psoriasis were asked if they thought it would be better, worse, or the same to have psoriasis, diabetes, asthma, or bronchitis, they said having psoriasis was better. But patients whohad both psoriasis and one of the other illnesses said having the skin disease was worse (<i>Br J Dermatol</i>. 1995;132:236-244). Patients may find skin diseases more disabling than some illnesses widely regarded as more serious, Andrew Finlay, MD, senior lecturer and consultant dermatologist at the University of Wales College of Medicine, Cardiff, Wales, said in a presentation at the annual meeting of the American Academy of Dermatology in San Francisco, Calif, in March. Skin diseases may substantially diminish a patient's quality of life (QOL), he said, restricting work, social, family, leisure, and sexual activities. Patients typically see these diseases as more troubling than their physicians do. Yet a physician's perception of a patient's emotional state, he noted,
Screening for the small-for-dates fetus.
Authors: R H Klipstein
Journal: BMJ (1980)

stood Mendelian inheritance well.They found it virtually impossible to accept the concept of the healthy carrier.The usual response was to agree politely that the child was perfectly healthy and did not need any treatment, but that children should be tested as young as possible-"so that it can be treated in time."Since completing this study we have been aware of the comparative simplicity of coun- selling families who come for testing, or have already been tested, if there is prior knowledge of their condition.They might, for example, have relatives with a haemoglobinopathy or trait, might have been tested themselves in pregnancy, or might have been referred by a doctor of their own ethnic background.We conclude that mass screening for haemo- globinopathy is unjustified, at least in this country.We advocate instead further health education about haemoglobinopathies together with financial support for hospitals recognised as able to offer both adequate testing and coun- selling.
Immunogenicity of Hepatitis B Vaccines
Authors: Raymond S. Koff
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Drs Margolis and Presson<sup>1</sup>have provided a well-reasoned Editorial on host factors relevant to the suboptimal response to recombinant hepatitis B vaccines (HBVs) observed among adults and reported in that issue of<i>JAMA</i>.<sup>2,3</sup>They point out that observed differences in response to the two commercially available recombinant HBVs (Engerix-B, SmithKline Beecham Pharmaceuticals, Philadelphia, Pa, and Recombivax HB, Merck Sharp &amp; Dohme, West Point, Pa) identified in one of the studies<sup>3</sup>must be viewed cautiously since the design of that study was retrospective. They also indicate that prospective studies are needed to answer the question of whether or not true differences in the immunogenicity of the two vaccines exist. A prospective, double-blind, randomized controlled trial comparing the two vaccines (20 μg of Engerix-B and 10 μg of Recombivax HB) in adults between 39 and 70 years of age (mean age, 49 years) has now been