tbuckley/cabot-search huggingface dataset:
Subacute encephalopathy associated with human immunodeficiency virus in haemophilia A.
Authors: A Rahemtulla, S T Durrant, J M Hows
Journal: BMJ (1986)

tion be part of the treatment of anorexia nervosa?Even though only some patients show depletion of tissue zinc, all patients require zinc as they regain weight.In extreme cases ofweight loss, or when patients fail to gain weight, supplementation is probably indicated.Zinc supplementation of subjects who are not deficient, however, may cause copper deficiency with anaemia and may impair immunity.At present, therefore, widespread,treatment of anorexia nervosa with zinc is not indicated.
Anomalous Case in a Child
Authors: D. W. Sargent
Journal: BMJ (1860)

and it did so.But there was no repression of the spasms as a result of its use; for twice it was given alone, and each time the spasms returned, to be reduced again by the aconite.Useful, then, in relieving a disagreeable accident, it had no power to stand against the tetanus.If I have succeeded in demonstrating the acute nature of the
THE ACTION OF HISTAMINE ON THE PANCREAS
Authors: A. V. Neale, T. G. Klumpp
Journal: Journal of Clinical Investigation (1930)

Claude Bernard (1856) and Heidenheim (1883) in their general physiological studies, initiated the earliest ideas of pancreatic function, but it remained for the classical experimental work of Pawlow (1901) and Bayliss and Starling (1902) to demonstrate the fundamental concepts of the physiology of the pancreas as a gland of external secre- tion.Pawlow observed that a flow of pancreatic juice occurred after the entry of the chyme into the duodenum.He suggested that this effect was due entirely to reflex vagal activity and supported this idea by obtaining a secretion on directly stimulating the vagi.That this was not the whole truth was shown by the experimental studies of Bayliss and Starling (1) in which it was indicated that pancreatic secretion could also be initiated by the contact of the duodenal mucosa with a weak acid solution, or by the injection of an extract of the mucosa itself; this whole phenomenon being due to the elaboration and circulation of a chemical stimulant of hormonic qualities.After extensive experiments these workers established the specificity of this hormonic stimulation, and noted the absence of any action on the salivary and gastric glands.This humoral theory was amply sup- ported by Farrell and Ivy (2) who obtained active and copious secre- tions in a denervated transplanted portion of the pancreas after the ingestion of a meal.This transplant also yielded a small continuous resting secretion containing the digestive enzymes.That the two methods of pancreatic stimulation induce secretions differing in composition is now well known,-"vagal" juice being small in volume but rich in protein and enzymes,-while "secretin" juice is copious in quantity, poor in proteins and enzymes but definitely alkaline due to the carbonate content.Atropine paralyzes the vagal Rockefeller Fellow in Pediatrics.
Pulmonary support using venovenous bypass and a biological oxygenator
Authors: G. L. Hammond, H. Poulain
Journal: Thorax (1974)

<b>Hammond, G. L., and Poulain, H. (1974).</b><i>Thorax</i><b>29</b>, 121-124. <b>Pulmonary support using venovenous bypass and a biological oxgenator.</b> A method of providing long-term pulmonary support without the use of an artificial oxygenator or systemic heparinization was investigated. Three groups of experiments were performed. Group I determined the bypass flow and blood oxygenator requirements of apnoeic animals supported by venovenous bypass. Group II and III experiments evaluated two different methods of oxygenating apnoeic test animals from adjacent parabiotic support animals. It was determined that a venovenous bypass ratio equal to cardiac output and a Po<sub>2</sub> of venous return blood of 150 mmHg was required to maintain satisfactory blood gases. These parameters were provided by support animals and sustained total respiratory support of the test animals for 48 hours.
Pain slowly surrenders its secrets as research
Authors: Carol Fletcher
Journal: JAMA (1984)

Developing safer opiates and a new class of nonopioid, centrally acting analgesics is among the goals of some 2,000 investigators who gathered in Seattle recently for the Fourth World Congress of the International Association for the Study of Pain. The diverse group of neurophysiologists, anesthesiologists, oncologists, pharmacologists, psychiatrists, and others attending the conference bears testimony to a burgeoning interest in pain research—a field that has blossomed, in the last two decades, on the borders between traditional disciplines. The potential impact of pain research is vast. In the United States alone, about 90 million people suffer from chronic pain, including the pain of low back ailments, arthritis, headaches, and cancer. John J. Bonica, MD, Department of Anesthesiology and Multidisciplinary Pain Center, University of Washington School of Medicine, Seattle, and past president of the association, says that pain accounts for 750 million lost work days a year and costs Americans at least
Managing transient ischaemic attack and ischaemic stroke
Authors: P J Martin, M E Gaunt, P R F Bell
Journal: BMJ (1992)

carotid stenosis of greater than 70% requiring endarterectomy.Of these 13 patients, 1-66 would have a stroke in the next three years, compared with 2-86 if no operations were performed-an annual saving of 1-2 strokes.Though such treatment is of paramount im- portance to those patients spared a stroke, in relative terms the need for high quality acute care and subsequent rehabilitation remains of prime importance to the 249 other patients who will continue to suffer strokes each year.
Abnormal radionuclide liver scans in giant cell arteritis.
Authors: J Jones, M V Kyle, B L Hazleman, P Wraight
Journal: Annals of the Rheumatic Diseases (1984)

In the investigation of six patients with giant cell arteritis and abnormal liver function radionuclide liver scans were found to be abnormal in all. The abnormality may be due to arteritis of hepatic vessels. It is important to recognise that giant cell arteritis may cause liver scan abnormalities. If other pathology is suspected and corticosteroid treatment delayed while further investigations are carried out, patients are at risk of complications such as blindness.
GMC: approaching the abyss
Authors: R. Smith
Journal: BMJ (2001)

The General Medical Council—unloved by patients, government, and doctors—is close to the abyss. What might push it over the edge in the next two months is the issue of its governance, 1 2 or if that doesn't get it revalidation might.3 The question that occurs to many is whether the council is worth all the effort necessary to save it. Might it be better to scrap what's become a dysfunctional organisation and start again?

The question of governance has the leaders of the GMC (and perhaps the government and some patient organisations) on one side and all the rest of doctors' organisations on the other. Yet there is still more agreement than disagreement. All the doctors agree that the council should be smaller, the proportion of lay members increased, and the council made more effective and efficient. The disagreement centres on the relative position and size of the bodies at the top. The GMC wants a small body at the top with the statutory powers and a larger body underneath. The BMA and the colleges want a larger, …
Gallbladder Disease
Authors: David Bainton, Gerald T. Davies, Kenneth T. Evans, I. Huw Gravelle
Journal: New England Journal of Medicine (1976)

In a weighted random sample of the specially enumerated population of a South Wales industrial town, examined by cholecystography for gallstones, the overall prevalence rates were 6.2 per cent for men 45 to 69 years of age and 12.1 per cent for women of the same ages. Contrary to our expectation there was no marked increase in prevalence with age in either sex. Symptoms of dyspepsia said to be suggestive of gallstones were found with approximately equal frequency in those with and without gallbladder disease.
Community-Based Prevalence of Anal Incontinence
Authors: Richard Nelson
Journal: JAMA (1995)

To determine the prevalence of and characteristics associated with anal incontinence in the general community.Community survey.The population of the state of Wisconsin sampled in the Wisconsin Family Health Survey. Subjects were identified by random digit dialing with telephone interview. The individual within each household identified as most knowledgeable about the health status of all other members of the household was asked about the health status of each member of the household. Approximately 200 households were surveyed each month.The presence of anal incontinence to solid or liquid feces or gas, who suffered from it, the frequency of anal incontinence, and how the incontinent person coped with it.A total of 2570 households comprising 6959 individuals were surveyed, and 153 individuals were reported to have anal incontinence, representing 2.2% of the population (95% confidence interval [Cl], +/- 0.3%). Thirty percent of the incontinent subjects were older than 65 years, and 63% were women. Of those with anal incontinence, 36% were incontinent to solid feces, 54% to liquid feces, and 60% to gas. In a multivariate analysis, independent associations of the following risk factors with anal incontinence were found: female sex (odds ratio [OR], 1.5; Cl, 1.1 to 2.1), age (continuously adjusted) (OR, 1.01; Cl, 1.01 to 1.02), physical limitations (OR, 1.8; Cl, 1.2 to 2.7), and poor general health (OR, 1.6; Cl, 1.4 to 1.9).Anal incontinence was reported in 2.2% of the general population. Independent risk factors for incontinence include female sex, advancing age, poor general health, and physical limitations.
Entrainment and interruption of atrial flutter with atrial pacing: studies in man following open heart surgery.
Authors: A L Waldo, W A MacLean, R B Karp, N T Kouchoukos, T N James
Journal: Circulation (1977)

To examine the question of why the pacing rate and duration of atrial pacing are crucial factors in the successful interruption of atrial flutter, studies were performed on 30 patients in the period following open heart surgery. In each patient the diagnosis of atrial flutter was made using a pair of wire electrodes placed on the right atrial epicardium at the time of operation and brought out through the anterior chest wall. The same electrodes were used for atrial pacing. Pacing faster than the spontaneous rate of the atrial flutter which failed to interrupt the atrial flutter was associated with transient entrainment of the atrial flutter up to the atrial pacing rate. Atrial flutter was interrupted successfully when the atria were paced at a rate which was too fast for the atrial flutter to follow. This was heralded by the conversion of previously negative flutter waves to positive atrial complexes in ECG lead II. When pacing the atria at a constant rate, 2-22 seconds with a mean of 10 seconds were required to interrupt the atrial flutter.
506. Transductional and Genome Biodistribution of Novel AAV Serotype Vectors after Systemic Delivery and Their Liver Specific Dose Response Profiles in Mice
Authors: You Lu, Guangping Gao, Julio Sanmiguel, Roberto Calcedo, Peter Bell, Nelson Wivel, James M. Wilson
Journal: Molecular Therapy (2005)

Recent discovery of a novel family of primate AAVs led to the developement of vectors with unprecedented efficiency in liver. To search for other potential applications of these vectors, we treated C57BL/6 mice intravenously with either 1|[times]|1011 or 1|[times]|1012 GC/mouse of AAVs 2, 5, 7, 8 and 9CBnLacZ. At days 3, 30 and 90, 13 tissues from treated animals were analyzed for LacZ expression by X-gal histochemical staining and vector genome quantification by TaqMan PCR. Analysis of day 3 samples revealed that AAVs 7, 8 and 9 derived vectors displayed more robust and broader tissue transduction profiles. Liver, cardiac and diaphragm muscles were the primary transduction targets by the 3 vectors. At the dose of 1|[times]|1011, more than 90% of hepatocyes were transduced by AAVs 8 and 9, 60-70% by AAV7. However, at a 10-fold higher dose, 100% of hepatocytes in all 3 vector groups stained blue. In the low dose groups, AAV9 transduced cardiac myocytes the best, followed by AAV8 and AAV7. But all 3 vectors achieved remarkable transduction in the heart at the high dose. All 3 novel vectors resulted in significant numbers of X-gal positive myocyte nuclei in the diaphragm muscle, particularly at the high dose. Hepatocyte transduction achieved by AAV 2 and AAV5 were only a few percent at the low dose but a clear dose response was observed in AAV2 high dose animals. No transduction events were detected in heart and diaphragm sections of the AAVs 2 and 5 treated animals. In addition, X-gal stained muscularis cells and smooth muscle cells of some tissues in GI track including stomach, small bowel and colon were readily noticeable in AAVs 7, 8 and 9 but not in the AAV2 and 5 groups. X-gal positive stromal cells but not follicles in the ovary were occasionally visible in all vector and dose groups. Several cell types including renal tubular cells in kidney were sporadically found to be transduced by AAVs 7, 8 and 9. These 3 vectors also transduced some acinar cells, interlobular connective tissues but rarely islets in pancreas. With all vector and dose groups, no transduction events were recognized in the brain, anterior tibialis muscle and lung tissues. In contrast to distinguished tissue transductional profiles of AAV serotype vectors, there was no serotype specific genome targeting observed. In most of tissues analyzed, genome copies of all rAAVs in a particular tissue are quite similar, suggesting that the capsid directed genome processing pathway represent the determining factor for the serotype specific vector biology.
Prognosis of lung cancer.
Authors: K. P. Duncan
Journal: BMJ (1968)

15 June, p. 643) describe the organization and methodology of a multiple screening programme in general practice.They make the valid point that within the context of our health care organization the logical place for screening is in, or in conjunction with, general practice.They pose the question as to what is the short-term or long-term effect of screening on the health of the patient.It must be regretted, how- ever, that this question is not given more prominence, nor will the design of their study allow any answer to be obtained.Numerous examples of screening pro- grammes have been reviewed by Wilson and Jungner.1 All of these, as well as Scott and Robertson, show that they can find a substan- dal amount of morbidity.There is no evi- dence, however, in any of these publications that in terms of subsequent morbidity and mortality the individual shown to have one or more of the conditions screened for has benefited.For many of the conditions for which screening is performed there is still little evidence that methods of treatment used improve prognosis.At this stage of our knowledge it is of great importance to assess the value of screen- ing examinations by properly controlled trials.Any general practitioner who wishes to embark on a screening programme must be urged to plan his study in such a way that he will be able to evaluate his findings rather than simply present a list of conditions discovered.--We are, etc.,
599 EVALUATION OF HEPATIC FIBROSIS BY TRANSIENT ELASTOGRAPHY (FIBROSCAN) IN METHOTREXATE- TREATED PATIENTS
Authors: A. Barbero-Villares, J. Mendoza, C. Esteban, E. Gomez-Dominguez, J.A. Moreno-Monteagudo, L. Garcia-Buey, R. Gomez-Gil, T. Sanz, E. Dauden, J. Mate, J.P. Gisbert, R. Moreno-Otero
Journal: Journal of Hepatology (2009)
Introduction to Clinical Skills: A Patient-Centered Textbook
Authors: Isaac Kleinman
Journal: Annals of Internal Medicine (1997)

Medical Writings15 December 1997Introduction to Clinical Skills: A Patient-Centered TextbookIsaac Kleinman, MDIsaac Kleinman, MDBaylor College of Medicine, Houston, TexasSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-12-199712150-00046 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Mengel MB, Fields SA; eds. 494 pages. New York: Plenum; 1997. $59.50. ISBN 0306453509. Order phone 800-221-9369.Field of medicine: Primary care.Format: Hardcover book.Audience: Primary care practitioners and students.Purpose: To provide an introductory text focusing on skills-beyond the routine diagnostic, treatment, and technical skills-that are useful in achieving optimal patient outcomes.Content: The book is divided into four sections. The first provides an overview of the dominant biomedical approach, which is followed by a chapter that contrasts that approach with a more “patient-centered” or “systemic” approach. Traditional interviewing and examining skills and use of the laboratory are ... Author, Article, and Disclosure InformationAffiliations: Baylor College of Medicine, Houston, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1997Volume 127, Issue 12Page: 1139KeywordsDecision makingGeriatricsResearch laboratories ePublished: 15 August 2000 Issue Published: 15 December 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Infants with suspected intestinal malrotation or volvulus are not prioritised for transfer
Authors: S. M. Mohinuddin, N. Ratnavel, A. K. Sinha
Journal: BMJ (2014)

Intestinal malrotation and volvulus in infants can be easily missed. The authors highlight the substantial risk of mortality and morbidity and recommend immediate surgical referral.1 In our experience as a regional neonatal transfer service for London, despite recognition of risks in infants with bilious vomiting, they are not prioritised for transfer to surgical centres.

We recently audited 163 term infants with bilious vomiting transferred at ≤7 days of …
Risk of inpatient falls is increased with single rooms
Authors: I. Singh, J. Okeke
Journal: BMJ (2013)

We recently compared a newly built Welsh hospital that has 100% single rooms with the old hospital, which has both single rooms and multi-bedded wards. In agreement with Pennington, we found that single rooms reduce the incidence of hospital acquired infections.1 Rates of acquisition of Clostridium difficile were also lower in the new hospital.2 As …
Evidence for differential effects of sulphasalazine on systemic and mucosal immunity in rheumatoid arthritis.
Authors: L Kanerud, G.N. Engström, A Tarkowski
Journal: Annals of the Rheumatic Diseases (1995)

To study the effects of sulphasalazine (SASP) on the systemic and mucosal humoral immune systems in patients with rheumatoid arthritis (RA). Serum concentrations of interleukin 6 (IL-6), class and subclass specific IgG, IgA and IgM, IgA and IgG antigliadin antibodies and rheumatoid factors (RF) of IgG, IgA (including IgA1 and IgA2 subclasses) and IgM isotypes were measured before and 16 weeks after sulphasalazine (SASP) therapy in 15 female and three male patients with RA. Amounts of immunoglobulins in saliva and jejunal fluid were measured as estimates of mucosal humoral immunity. Serum concentrations of IgA and IgG decreased significantly during SASP therapy and correlated with reduced concentrations of IL-6. In addition, levels of circulating IgA RF, IgA anti-gliadin antibodies and IgM RF decreased significantly after the treatment. In contrast, immunoglobulin levels in saliva and jejunal fluid were unaltered. SASP exerts powerful but selective inhibitory effects on systemic immunoglobulin production, whereas no effects on mucosal immunoglobulin production were observed. The decreased systemic B cell activity may be mediated by downregulation of the production of IL-6, a cytokine with Ig switching properties.
593 LENALIDOMIDE AMELIORATES THE PORTAL HYPERTENSIVE SYNDROME IN NON-CIRRHOTIC AND CIRRHOTIC PORTAL HYPERTENSIVE ANIMALS
Authors: B. Payer, T. Reiberger, P. Schwabl, T. Horvatits, V. Fuhrmann, B. Angermayr, M. Peck-Radosavljevic
Journal: Journal of Hepatology (2013)
Psychiatric Social Work: A Transactional Case Book
Authors: Maurice F. Connery
Journal: JAMA (1962)

In an era that has witnessed a marked decrease in published reports of clinical therapeutic practice, this book comes as a most welcome and valuable contribution to clinical literature. The report is the result of a 10-year examination of practice in an outpatient psychiatric clinic by 4 social workers and an experienced psychiatric practitioner. The reason for the decline of such clinical studies is not hard to discern. The past decade has witnessed the rise of empirical, clinical investigations, and a concerted effort to construct theories of personality that conform more closely to the canons of scientific method. In such a climate, reports of their practice by clinicians who have lacked this theoretical sophistication, or whose observations could not always be expressed in chi squares and probability tables have received little attention. Most clinicians were aware that there was need for more careful formulations of personality theory. Yet as time
The Origins of Bilirubin
Authors: Stephen H. Robinson
Journal: New England Journal of Medicine (1968)

JAUNDICE has classically been considered to be due either to impaired excretion of bilirubin by the liver or to overproduction of this pigment as the result of hemolytic disease. Recent advances in this area are amplifying this traditional concept. Although most of the bile pigment produced under normal conditions is derived from hemoglobin heme in senescent red blood cells, it is now recognized that some bilirubin originates from other sources, each of which is a potential cause of hyperbilirubinemia. Disordered erythropoiesis in the bone marrow has been implicated as a mechanism of jaundice in several clinical studies, and recent experiments . . .
Use and abuse of performance indicators.
Authors: P. W. Skinner, D. Riley, E. M. Thomas
Journal: BMJ (1988)

An audit was performed by this department after allegations by the regional health authority of low productivity. It was found that the health authority had underestimated the number of operations performed in 1983 by only 5%, but an inexact classification and grading of operations had led to errors in the performance indicators of 19.8% for the "weighted number of operations" and 34.5% for the "number of major operations per consultant." When the throughput of orthopaedic departments in districts was compared by the regional health authority it was found that such errors in performance indicators had been further compounded by the inconsistent use of population data and incorrect data on medical staffing. Medical practitioners and the health authorities are alerted to this amplification of inaccurate data. Other methods for assessing trauma and orthopaedic surgery are proposed, such as a simplification of the Office of Population Censuses and Surveys classification of surgical operations, grading operations based on time spent in the operating theatre, and provision of computer programs to code for diagnosis and operation when writing discharge summaries.