tbuckley/cabot-search huggingface dataset:
The Usefulness of a Predictive Instrument to Reduce Inappropriate Admissions to the Coronary Care Unit
Authors: MICHAEL W. POZEN
Journal: Annals of Internal Medicine (1980)

A mathematical instrument was developed to supplement the diagnostic information available to physicians in the emergency room to improve physicians' diagnostic accuracy in managing patients with acute ischemic heart disease and thereby reduce inappropriate coronary care unit admissions. The instrument was empirically derived and is based on nine clinical, historical, and electrocardiographic predictive variables. Probabilities of acute ischemic heart disease generated by the instrument were given to the house staff in an emergency room during alternate months. Comparison of the control months (455 patients) with the experimental months (401 patients) showed the following: The overall diagnostic accuracy increased from 83% to 91% (P < 0.005), the overdiagnostic accuracy increased from 51% to 33% (P < 0.01), and the admission rate to the coronary care unit fell from 26% to 14% (P < 0.001), while the inappropriate discharge rate from the emergency room did not change, 3% versus 3% (not significant).
A double-blind controlled trial of azathioprine in chronic actinic dermatitis
Authors: G.M. Murphy, P.D.L. Maurice, P.G. Norris, J.L.M. Hawk
Journal: British Journal of Dermatology (1987)

Chronic actinic dermatitis is a rare, idiopathic, eczematous photodermatosis which is usually severe and refractory to treatment, although spontaneous improvement may occur.1 Retrospective assessment has indicated that azathioprine may be a useful mode of treatment.2 A doubleblind controlled trial was therefore carried out to confirm its efficacy. All patients were investigated by irradiation monochromator testing of the skin of the back to establish abnormal reactions to ultraviolet (UV) and visible radiation. Patch and photopatch tests excluded causative allergic contact and photocontact dermatitis. Eighteen severely affected patients were sequentially and randomly allocated to azathioprine 50 mg t.d.s. or placebo therapy over a 2year period. Patients wore polysulphonefilm lapel badges, changed weekly throughout the trial. The change in absorbance of the polysulphone film as measured spectrophotometrically before and after exposure enabled quantification of ambient exposure to UVB radiation. Patients documented severity of itching and rash weekly on a 10 cm visual analogue scale. Rash, corticosteroid use and sunscreen use were assessed monthly at the clinic, as were haematology, liver function and renal function. Six men and two women (mean age 64 years) received active and 10 men (mean age 66 years) placebo therapy. Patients on active treatment had more severe clinical features and monochromator test reactions than those on placebo at the start of the trial. Mean duration of treatment was 8·4 months, range 1·5–12 months (active group) and 4·1 months, range 0·1-12 months (placebo group). Mean weekly UV exposure was greater in active group patients. Five of eight azathioprine-treated patients achieved remission and one improved within 3–12 months, one did not improve over 8 weeks and one defaulted early with gastrointestinal upset. None of 10 placebo patients improved, three defaulted within 1 month, the remainder being assessed for 3–12 months. The markedly and significantly better clinical status of actively treated patients (P≤0·001; chi-squared test) led to early termination of the trial. Thus azathioprine therapy is a well-tolerated effective treatment in chronic actinic dermatitis.
Plasmid DNA encoding transforming growth factor-beta1 suppresses chronic disease in a streptococcal cell wall-induced arthritis model.
Authors: X Y Song, M Gu, W W Jin, D M Klinman, S M Wahl
Journal: Journal of Clinical Investigation (1998)

Transforming growth factor beta is a potent immunomodulator with both pro- and antiinflammatory activities. Based on its immunosuppressive actions, exogenous TGF-beta has been shown to inhibit autoimmune and chronic inflammatory diseases. To further explore the potential therapeutic role of TGF-beta, we administered a plasmid DNA encoding human TGF-beta1 intramuscularly to rats with streptococcal cell wall-induced arthritis. A single dose of 300 microg plasmid DNA encoding TGF-beta1, but not vector DNA, administered at the peak of the acute phase profoundly suppressed the subsequent evolution of chronic erosive disease typified by disabling joint swelling and deformity (articular index = 8.17+/-0. 17 vs. 1.25+/-0.76, n = 6, day 26, P < 0.01). Moreover, delivery of the TGF-beta1 DNA even as the chronic phase commenced virtually eliminated subsequent inflammation and arthritis. Both radiologic and histopathologic as well as molecular evidence supported the marked inhibitory effect of TGF-beta1 DNA on synovial pathology, with decreases in the inflammatory cell infiltration, pannus formation, cartilage and bone destruction, and the expression of proinflammatory cytokines that characterize this model. Increases in TGF-beta1 protein were detected in the circulation of TGF-beta1 DNA-treated animals, consistent with the observed therapeutic effects being TGF-beta1 dependent. These observations provide the first evidence that gene transfer of plasmid DNA encoding TGF-beta1 provides a mechanism to deliver this potent cytokine that effectively suppresses ongoing inflammatory pathology in arthritis.
Absorption of therapeutic preparations of iron measured with a whole body counter
Authors: S. T. Callender, G. T. Warner
Journal: BMJ (1969)

The Oxford Whole Body Counter was used to measure absorption from various therapeutic preparations of iron in five groups of subjects. Succinic acid enhanced absorption of iron when added to a solution of ferrous fumarate, but not when given with tablets of ferrous fumarate or ferrous sulphate. Ferrous fumarate plus ascorbic acid was absorbed better than ferrous fumarate alone but no better than ferrous sulphate. The addition of ascorbic acid and succinic acid to tablets of ferrous sulphate did not enhance absorption significantly.
Potentially Misleading Bone Scan Findings in Patients With Hepatoblastoma
Authors: DEREK ARCHER, PAUL BABYN, DAVID GILDAY, MARK A. GREENBERG
Journal: Clinical Nuclear Medicine (1993)

Eleven patients who underwent nuclear medicine bone scanning were reviewed to determine the incidence of bone scan abnormalities associated with hepatoblastoma. Of these, six patients had abnormal bone scan findings--four with focal involvement. Correlating plain radiographs and/or follow-up nuclear bone scans were available for three of these four. All plain films indicated the presence of osteoporosis. Follow-up scans showed improvement or resolution of abnormalities. None of the patients had documented metastatic bone disease. While there has been no prior reported association, the authors attribute the abnormal bone scan findings to a paraneoplastic syndrome of osteoporosis associated with this primary tumor. They conclude that bone scanning is not routinely indicated in the initial diagnostic staging of hepatoblastoma.
GPs reluctant to cover out of hours work, survey shows
Authors: N. Koralage
Journal: BMJ (2004)

Just half of GPs will work out of hours under new contracts, according to a survey questioning more than 1000 doctors. Published in Pulse magazine, the survey also says 62% of GPs believe patients will be less safe when primary care organisations take over night and weekend cover.

The new contracts are designed to halt the recruitment crisis in general practice and benefit the lives of family doctors. But, according to Pulse , GPs said using more nurses, pharmacists, and paramedics to aid the primary care organisations and reduce costs could …
Effect of Clinician Communication Skills Training on Patient Satisfaction
Authors: Jonathan Betz Brown, Myde Boles, John P. Mullooly, Wendy Levinson
Journal: Annals of Internal Medicine (1999)

Background: Although substantial resources have been invested in communication skills training for clinicians, little research has been done to test the actual effect of such training on patient satisfaction. Objective: To determine whether clinicians' exposure to a widely used communication skills training program increased patient satisfaction with ambulatory medical care visits. Design: Randomized, controlled trial. Setting: A not-for-profit group-model health maintenance organization in Portland, Oregon. Participants: 69 primary care physicians, surgeons, medical subspecialists, physician assistants, and nurse practitioners from the Permanente Medical Group of the Northwest. Intervention: “Thriving in a Busy Practice: Physician-Patient Communication,” a communication skills training program consisting of two 4-hour interactive workshops. Between workshops, participants audiotaped office visits and studied the audiotapes. Measurements: Change in mean overall score on the Art of Medicine survey (HealthCare Research, Inc., Denver, Colorado), which measures patients' satisfaction with clinicians' communication behaviors, and global visit satisfaction. Results: Although participating clinicians' self-reported ratings of their communication skills moderately improved, communication skills training did not improve patient satisfaction scores. The mean score on the Art of Medicine survey improved more in the control group (0.072 [95% CI, −0.010 to 0.154]) than in the intervention group (0.030 [CI, −0.060 to 0.120]). Conclusions: ”Thriving in a Busy Practice: Physician-Patient Communication,” a typical continuing medical education program geared toward developing clinicians' communication skills, is not effective in improving general patient satisfaction. To improve global visit satisfaction, communication skills training programs may need to be longer and more intensive, teach a broader range of skills, and provide ongoing performance feedback.
Geographical differences in prevalence of hepatitis C virus infection in PCT (porphyria cutanea tarda)
Authors: L. Malina, J. Stransky, E. ŽDarsky
Journal: British Journal of Dermatology (1997)

Journal Article Geographical differences in prevalence of hepatitis C virus infection in PCT (porphyria cutanea tarda) Get access L. Malina, L. Malina Dermatological Department, 3rd Medical Faculty, Charles University. Prague, Czech Republic Search for other works by this author on: Oxford Academic Google Scholar J. Stransky, J. Stransky 1st Department of Medicine, 3rd Medical Faculty, Charles University. Prague, Czech Republic Search for other works by this author on: Oxford Academic Google Scholar E. ŽDarsky E. ŽDarsky Department of Immunology, 3rd Medical Faculty, Charles University. Prague, Czech Republic Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 136, Issue 2, 1 February 1997, Pages 291–292, https://doi.org/10.1111/j.1365-2133.1997.tb14922.x Published: 01 February 1997
Use of Human Immunodeficiency Virus-1 Protease Inhibitors Is Associated With Atherogenic Lipoprotein Changes and Endothelial Dysfunction
Authors: James H. Stein, Melissa A. Klein, Jennifer L. Bellehumeur, Patrick E. McBride, Donald A. Wiebe, James D. Otvos, James M. Sosman
Journal: Circulation (2001)

Human immunodeficiency virus protease inhibitors (HIV PIs) are associated with hyperlipidemia, hyperglycemia, and obesity; however, it is not known whether they increase risk of atherosclerotic vascular disease. The purposes of this study were to characterize the lipoprotein abnormalities associated with use of HIV PIs in individuals with HIV infection and to determine the pathophysiological significance of these changes by assessing their effect on endothelial dysfunction.This was a cross-sectional study of 37 adults with HIV-1 infection who were receiving antiretroviral therapy. Twenty-two were taking HIV PIs (group 1); 15 were not (group 2). Lipids and lipoproteins were measured by enzymatic techniques and nuclear magnetic resonance spectroscopic analysis. Flow-mediated vasodilation (FMD) of the brachial artery was measured by high-resolution ultrasound. Subjects in both groups were similar in regard to age, time since diagnosis of HIV infection, and CD4 cell count. Group 1 subjects had higher total cholesterol (5.68 versus 4.42 mmol/L, P=0.007) and triglyceride (4.43 versus 1.98 mmol/L, P=0.009) levels, characterized by elevated levels of IDL and VLDL. Subjects in group 1 had impaired FMD (2.6+/-4.6%), indicative of significant endothelial dysfunction. Group 2 subjects had normal FMD (8.1+/-6.7%, P=0.005). In group 1, chylomicron, VLDL, IDL, and HDL cholesterol levels predicted FMD.Use of HIV PIs is associated with atherogenic lipoprotein changes and endothelial dysfunction. Because these metabolic and vascular changes predispose to atherosclerosis, monitoring and treatment of dyslipidemia in patients taking these medications is warranted.
Cholinergic dysfunction in a mouse model of Alzheimer disease is reversed by an anti-A antibody
Authors: K. R. Bales
Journal: Journal of Clinical Investigation (2006)

Disruption of cholinergic neurotransmission contributes to the memory impairment that characterizes Alzheimer disease (AD). Since the amyloid cascade hypothesis of AD pathogenesis postulates that amyloid beta (A beta) peptide accumulation in critical brain regions also contributes to memory impairment, we assessed cholinergic function in transgenic mice where the human A beta peptide is overexpressed. We first measured hippocampal acetylcholine (ACh) release in young, freely moving PDAPP mice, a well-characterized transgenic mouse model of AD, and found marked A beta-dependent alterations in both basal and evoked ACh release compared with WT controls. We also found that A beta could directly interact with the high-affinity choline transporter which may impair steady-state and on-demand ACh release. Treatment of PDAPP mice with the anti-A beta antibody m266 rapidly and completely restored hippocampal ACh release and high-affinity choline uptake while greatly reducing impaired habituation learning that is characteristic of these mice. Thus, soluble "cholinotoxic" species of the A beta peptide can directly impair cholinergic neurotransmission in PDAPP mice leading to memory impairment in the absence of overt neurodegeneration. Treatment with certain anti-A beta antibodies may therefore rapidly reverse this cholinergic dysfunction and relieve memory deficits associated with early AD.
Short-Term Corticosteroid Therapy in Combination With Lamivudine: A Case of Déjà Vu?
Authors: Robert P. Perrillo
Journal: Hepatology (2000)

HepatologyVolume 32, Issue 3 p. 663-665 EditorialFree Access Short-Term Corticosteroid Therapy in Combination With Lamivudine: A Case of Déjà Vu? Robert P. Perrillo M.D., M.D., Corresponding Author Robert P. Perrillo M.D., M.D. rperrillo@ochsner.org Section of Gastroenterology, Ochsner Clinic, New Orleans, LASection of Gastroenterology, Ochsner Clinic, 9th Floor, 1514 Jefferson Highway, New Orleans, LA 70121. fax: 504-842-7466.===Search for more papers by this author Robert P. Perrillo M.D., M.D., Corresponding Author Robert P. Perrillo M.D., M.D. rperrillo@ochsner.org Section of Gastroenterology, Ochsner Clinic, New Orleans, LASection of Gastroenterology, Ochsner Clinic, 9th Floor, 1514 Jefferson Highway, New Orleans, LA 70121. fax: 504-842-7466.===Search for more papers by this author First published: 30 December 2003 https://doi.org/10.1053/jhep.2000.16662Citations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume32, Issue3September 2000Pages 663-665 ReferencesRelatedInformation
Satan and the Stethoscope
Authors: B. H. BASS
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 May 1973Satan and the StethoscopeB. H. BASS, M.D., F.R.C.P.B. H. BASS, M.D., F.R.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-5-791 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I was interested to see the letter by Drs. Malek and Glushien (p. 1004 of your December 1972 issue). When the pseudotachyarrhythmia showed up on the monitor, would it not have saved a lot of trouble if the physician had applied his stethoscope to the patient's praecordium?... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: B. H. BASS, M.D., F.R.C.P.Affiliations: Department of Medicine Good Hope General Hospital Sutton, Coldfield, Warwickshire England PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1973Volume 78, Issue 5Page: 791-791 ePublished: 1 December 2008 Issue Published: 1 May 1973 PDF downloadLoading ...
Smoking Status Is a Risk Factor for Recurrence After Transurethral Resection of Non–Muscle-Invasive Bladder Cancer
Authors: Rianne J.M. Lammers, Wim P.J. Witjes, Kees Hendricksen, Christien T.M. Caris, Maria H.C. Janzing-Pastors, J. Alfred Witjes
Journal: European Urology (2011)
Francis Isidore Rackow
Authors: Malcolm Hodkinson
Journal: BMJ (2004)

A pioneer of hypotensive anaesthesiaHale Enderby is best known for his pioneering work in hypotensive anaesthesia.This is the technique of lowering blood pressure during surgery, making operations safer and more rapid, and enabling more complicated surgery while controlling blood loss from the patient.In 1948-9 the pharmacologists Paton and Zaimis first described a range of new drugs, the methonium compounds, some of which could lower blood pressure.Hale Enderby saw that this fall in blood pressure could be used to lessen bleeding during surgery-the snag was measuring the low blood pressures.Early methods of measurement relied on using a mercury column, but the Korotkov sounds become inaudible below 60 mm Hg systolic.The pulse also becomes impalpable at that pressure.However, this was the level of blood pressure needed to reduce bleeding significantly.Hale Enderby introduced into anaesthesia the oscillometer, an older and largely forgotten method of blood pressure measurement but one that proved capable of measuring accurately these low pressures.He was also responsible for introducing the "anti-trendelenburg" or head-up tilt of the operating table to assist in the lowering of blood pressure.George Edward Hale Enderby was born in Boston, Lincolnshire.At the start of the second world war he joined the emergency medical service after being turned down for active military service because of a duodenal ulcer.He worked initially at Guy's Hospital and then at Pembury Hospital, Kent, to which many of the Guy's facilities were moved after the hospital was bombed at the start of the war.It was there that he was asked to move into anaesthesia.He organised most of his training himself by reading and visiting notable anaesthetists of the day.
Removal of an Inverted Uterus
Authors: J. B. Harrison
Journal: BMJ (1858)

we exclude that insight of the understanding which is called intuition, because it is a part of its own innate energy which depends neither on memory nor the senses, though called into activity through their exercise.There can be no difficulty, then, in admitting that the disease under consideration exists in the only otlher set of faculties remaining; that its exciting cause is disease of the material organ in which they inhere; and that its proximate cause is a perversion of the logical understanding, and through it a perversion also o' the feelings and the will.Insanity, then, may be defined as-a dangerous mis- conception of one's personal relations, either persistent or with lucid intervals, and with or without illusions of the senses.It will give more completeness to this sketch if I add, that a true conception of the understanding is an idea or belief in confo;mity with the nature of things, and that the class of mis- conceptions may be tabulated as under:-KISCONCEPTION.1.In matters common to all men: Error and Ignorance.2. Peculiarities gradually acquired from circumstances: Eccentricity.3. Peculiarities suddenly or recently coming on from dis- ease: some forms of Monomania. 4. In which liberty is dangerous to the Individual and to Society: Insanity.a. From destruction of all mental power-De- mentia.b& From general weakness of mental power
A LESSON TO REMEMBER
Authors: J N S Simpson
Journal: BMJ (1996)

The wrong x ray

I was an orthopaedic registrar in a hospital group and scheduled to start the operating list in the main hospital. The first case was excision of fractured head of left radius. The patient had been seen by the consultant in an outlying hospital and admitted the day before and checked by the senior house officer but the first time I saw him was when he was wheeled into …
Newcastle-On-Tyne Infirmary: Practice of Sir John Fife. Removal of Tumor from Beneath Lower Jaw
Authors: J. Mitchell
Journal: BMJ (1842)

<h3>Objective</h3> In a national study of Australian children aged 11–12 years old, we examined the (1) prevalence and characteristics of hearing loss, (2) its demographic risk factors and (3) evidence for secular increases since 1990. <h3>Methods</h3> This is a cross-sectional CheckPoint wave within the Longitudinal Study of Australian Children. 1485 children (49.8% retention; 49.7% boys) underwent air-conduction audiometry. Aim 1: hearing loss (≥16 decibels hearing level (dB HL)) was defined in four ways to enable prior/future comparisons: high Fletcher Index (mean of 1, 2 and 4 kHz; primary outcome relevant to speech perception), four-frequency (1, 2, 4 and 8 kHz), lower frequency (1 and 2 kHz) and higher frequency (4 and 8 kHz); aim 2: logistic regression of hearing loss by age, gender and disadvantage index; and aim 3: P for trend examining CheckPoint and reported prevalence in studies arranged by date since 1990. <h3>Results</h3> For high Fletcher Index, the prevalence of bilateral and unilateral hearing loss ≥16 dB HL was 9.3% and 13.3%, respectively. Slight losses (16–25 dB HL) were more prevalent than mild or greater (≥26 dB HL) losses (bilateral 8.5% vs 0.8%; unilateral 12.5% vs 0.9%), and lower frequency more prevalent than higher frequency losses (bilateral 11.0% vs 6.9%; unilateral 15.4% vs 11.5%). Demographic characteristics did not convincingly predict hearing loss. Prevalence of bilateral/unilateral lower and higher frequency losses ≥16 dB HL has risen since 1990 (all P for trend &lt;0.001). <h3>Conclusions and relevance</h3> Childhood hearing loss is prevalent and has risen since 1990. Future research should investigate the causes, course and impact of these changes.