tbuckley/cabot-search huggingface dataset:
Quantifying treatment effects in randomised controlled trials
Authors: P. Sedgwick
Journal: BMJ (2015)

Researchers investigated the efficacy of varenicline in helping users of smokeless tobacco to quit. Varenicline is a licensed cigarette smoking cessation aid. A randomised double blind placebo controlled trial was performed. The intervention was varenicline 1 mg twice daily delivered for 12 weeks, with 14 weeks’ follow-up. Participants were users of smokeless tobacco who wished to quit, aged 18 years or more. In total, 431 participants were recruited and randomised to varenicline (n=213) or placebo (n=218). All participants were offered brief behavioural support or counselling at the discretion of the investigators.1

The primary endpoint was continuous abstinence for four weeks at the end of treatment (weeks 9-12) confirmed by cotinine concentration. A higher rate of abstinence was reported in the varenicline group than in the placebo group (59% v 39%; unadjusted relative risk 1.51, 95% confidence interval 1.23 to 1.84; number needed to treat 5). A higher proportion of the varenicline group reported an adverse event compared with the placebo group (79% v 58%; number needed to harm 4.76). The researchers concluded that varenicline could help people to give up smokeless tobacco and that it had an acceptable safety profile.

Which of the following statements, if any, are true?

Statements a, c, and d are true, whereas b is false.

Smokers sometimes use …
Focus: Westminster: Government stumbles over diability bill
Authors: J Warden
Journal: BMJ (1994)

On the day the Labour leader, John Smith, died last month talks were due to have taken place between the government and the opposition about changing the working life of MPs, especially their addiction to unsocial hours. Plans to reform the House of Commons - morning sittings, earlier nights, and free Fridays - now await the advent of Labour's new leader. The motivation for changing parliament's ways is partly a perception that it imposes an undue stress on its members and perhaps puts their lives at risk.

Evidence for this is equivocal. The average age of MPs dying in the course of the last parliament was 56. John Smith was 55, exactly the average of the eight MPs who have died in the first two years of the present parliament. But if this suggests a pattern of premature deaths they cannot on examination …
Percutaneous Transhepatic Cholelithotripsy for Difficult Common Bile Duct Stones
Authors: J. G. Stage, F. Moesgaard, S. Grønvall, P. Stage, H. Kehlet
Journal: Endoscopy (1998)

A study was carried out to assess the feasibility of a new rapid technique for percutaneous transhepatic access to the biliary tract with endoscopic lithotripsy (percutaneous transhepatic cholelithotripsy).14 patients with biliary stones resistant to endoscopic retrograde cholangiography and extracorporeal shock wave lithotripsy underwent cholelithotripsy, utilizing a new dilation kit with massive teflon dilators covered by "peel-away sheets".Successful lithotripsy was performed in all patients by laser lithotripsy through a choledochoscope or ureteroscope in ten patients and by stone removal by basket in the remaining four patients. The procedure was carried out using local anesthesia in the last 11 patients. Except for two patients with transient cholangitis, no complications occurred.Difficult bile duct and intrahepatic stones can be treated successfully with a simple percutaneous transhepatic cholelithotripsy procedure including local anesthesia, dilation and stone clearance.
Structural and therapeutic insights from the species specificity and in vivo antithrombotic activity of a novel αIIb-specific αIIbβ3 antagonist
Authors: Robert Blue, M. Anna Kowalska, Jessica Hirsch, Marta Murcia, Christin A. Janczak, Amanda Harrington, Marketa Jirouskova, Jihong Li, Rudy Fuentes, Michael A. Thornton, Marta Filizola, Mortimer Poncz, Barry S. Coller
Journal: Blood (2009)
Subfertility in men Measurement error and confounding not accounted for
Authors: D Gregson, E Smyth, J Flowers, F J Steward, A J Hill, R J Lilford
Journal: BMJ (1994)

EDITOR, - Richard Lilford and colleagues conclude that subfertility in men is familial and that their observations are consistent with a genetic cause.1 Measurement error and confounding may provide alternative explanations.

In case-control studies it is essential that the data collected from cases and controls should be of comparable accuracy - a requirement not met by this study, in which infertility in the brothers of cases and controls was assessed on hearsay evidence. The reasons for childlessness are more likely to be explored when two brothers are childless than when one brother is fertile and the other childless. Subfertile men may actively seek the explanation of their brother's childlessness in an attempt to explain their own subfertility. Cases and controls may interpret unexplained childlessness from their own experience as involuntary or voluntary. Additional bias may be introduced if the collection of information was not blinded. The use of reported childlessness also assumes that all such childlessness is due to male subfertility, the partner's contribution being ignored. Misclassification could easily explain these results.

We agree that the difference in …
Treatment of Mania with Cinanserin, an Antiserotonin Agent
Authors: FRANCIS J. KANE
Journal: American Journal of Psychiatry (1970)

Cinanserin, a new drug with antiserotonin activity, produced a rapid remission of the manic phase of manic-depressive psychosis in five of seven cases described by the author. No significant toxicity was encountered. The findings indicate that this drug deserves further clinical study.
TUBERCULOSIS OF LUNGS AND BRONCHIAL LYMPH NODES
Authors: EUGENE L. OPIE
Journal: JAMA (1927)

Discussion concerning tuberculosis in childhood cannot be limited to a consideration of manifest disease but must include all forms of partially concealed infection. Under the topics that have been assigned as a part of the symposium, I shall consider both latent and clinically recognizable disease. <h3>INCIDENCE</h3> Knowledge of the incidence of tuberculosis in infancy and early childhood is in large part based on mortality statistics which, in view of untrustworthy criteria for the diagnosis of tuberculosis in childhood, are notably uncertain. It is well known that the mortality rate from the disease begins to rise within several months after birth, and reaches a peak during the first year of life. A rapid fall begins during the second half of the first year, and from the end of the second to the fifteenth year the curve maintains a uniformly low level, but from adolescence through early adult life it rises continuously.
Physicians on Aeromedical Teams
Authors: Colin F. Mackenzie
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Baxt and Moody<sup>1</sup>report the survival of eight more patients with blunt trauma who were transported by helicopter with a flight nurse and physician than survived following transport with a flight nurse and paramedic. We think their conclusion that a flight physician influences patient outcome is premature because of the small number of fatalities in their patient population. They provide infor mation about treatment and errors, but there is little data identifying the actual injuries received and there is no autopsy information on patients that died to confirm or refute the clinical determination of injury and errors in management. <h3>Study.—</h3> We examined autopsy data from 300 (98.3%) of 305 patients who died within 24 hours of injury among a population of 2579 patients injured in road traffic accidents who were transported by helicopter with emergency medical technicians.<sup>2</sup>We identified from the autopsy and clinical findings
THE THERAPEUTIC USE OF OXYGEN
Authors: ALVAN L. BARACH
Journal: JAMA (1922)

The use of oxygen in medical therapy occupies at present an uncertain rôle. Previous to the recent war, the current attitude was that of indifference to its use and skepticism concerning its value. This attitude appeared to be based not on inaccurate observation, but for the most part on the true appraisal of results obtained from ineffective methods. The lack of enthusiasm with which oxygen has been regarded in the past seems largely due to the absence of an ideal method of administering it. There is no commonly available method that can supply to the patient an effective concentration of oxygen without in some degree interfering with his comfort. The apparatus most widely used in this country and in England, the tube and funnel, adds less than 2 per cent. oxygen to the inspired air.<sup>1</sup>In short, oxygen was not given in sufficient dosage to get the therapeutic effect.
Hyaluronic Acid-Stimulating Activity in the Pathophysiology of Wilms' Tumors
Authors: M. T. Longaker, N. S. Adzick, D. Sadigh, B. Hendin, S. E. Stair, B. W. Duncan, M. R. Harrison, R. Spendlove, R. Stern
Journal: JNCI Journal of the National Cancer Institute (1990)

Markedly elevated levels of hyaluronic acid occur in the serum and urine of some patients with Wilms’ tumor. We have recently described a glycoprotein factor in fetal serum that stimulates deposition of hyaluronic acid. In a survey of bovine fetal tissue extracts, we have identified the fetal kidney as the source of this circulating activity. Wilms‘ tumors arise from transformed “rests” of fetal kidney. We demonstrate here that such tumors continue to produce this fetal factor and that the hyaluronic acid-stimulating activity is found in the urine of children with Wilms’ tumors. In the three patients with Wilms‘ tumor who were followed, elevated levels of hyaluronic acid-stimulating activity were found in their urine before treatment. By 2 months after surgical removal of their tumors, these levels had returned to baseline. We propose that hyaluronic acid-stimulating activity is the mechanism for the elevated levels of hyaluronic acid in the sera and urine of these patients. The activity is an oncofetal protein and the first for which a function has been identified. It also is a marker for this common childhood solid tumor and has the potential for identifying children at increased risk. [J Natl Cancer Inst 82: 135–139, 1990]
More Evidence for Coronary Calcium as a Measure of Cardiovascular Risk
Authors: Philip Greenland
Journal: JAMA (2013)

Prevention is a valued goal in both public health and clinical medicine, but the methods differ. In clinical medicine, the focus is on the individual patient and “personalized” assessment and intervention are highly desirable. Thus, in prevention of coronary heart disease (CHD), while the public health approach recommends dietary and other lifestyle measures that apply across a wide swath of the population, the clinical approach looks to identify the high-risk individuals within the population for targeted interventions. Therefore, clinicians dealing with individual patients wish to have predictive models and treatment algorithms that will enable personalized approaches. Ideally, each patient is assessed for a distinctive and specific risk of disease development or complications of an existing disease. As genomic and molecular research has advanced, the expectation of improved prediction and more specific personalization has become even more highly expected than in previous years.1
Visualization of Calculus In Lower Ureter
Authors: Willard E. Goodwin
Journal: JAMA (1972)

<h3>To the Editor.—</h3> It was particularly interesting for me to see the LETTER inThe Journal(<b>219</b>:621, 1972) on the subject, "Bladder Filling Maneuver for Visualization of Calculus in Lower Ureter." We employed this years ago, but abandoned it in favor of an even simpler and more useful technique when the situation described of an indefinite calculus in the lower part of the ureter is suspected. Very good films can be obtained by filling the bladder with air. This has the same effect of pushing the intestine out of the pelvis and it also makes a sharper contrast for poorly opacified calculi.
Impact of gender on the incidence and outcome of contrast-induced nephropathy after percutaneous coronary intervention
Authors: Ioannis Iakovou, G. Dangas, A.J. Lansky, M. Negoita, I. Hjazi, D. Ashby, C. Costantini, M. Guiry, R. Brandwein, M. Losquadro, J. Forman, J.W. Moses, G.W. Stone, M.B. Leon, R. Mehran
Journal: Journal of the American College of Cardiology (2002)
Percutaneous Coronary Intervention After Subcutaneous Enoxaparin Pretreatment in Patients With Unstable Angina Pectoris
Authors: J. Ph. Collet, G. Montalescot, L. Lison, R. Choussat, A. Ankri, G. Drobinski, I. Sotirov, D. Thomas
Journal: Circulation (2001)

Background —Subcutaneous low-molecular-weight (LMW) heparins can effectively replace unfractionated heparin in patients with unstable angina or non–Q-wave myocardial infarction. However, the optimal anticoagulation strategy for these patients when they require cardiac catheterization is still unclear. Therefore, we evaluated a new and simple strategy of anticoagulation in these patients. Methods and Results —A total of 451 consecutive patients with unstable angina/non–Q-wave myocardial infarction were treated for at least 48 hours with subcutaneous injections of enoxaparin (1 mg [100 IU]/kg every 12 hours, cycled at 6 AM and 6 PM). Of this unselected population, 293 patients (65%) underwent a coronary angiography within 8 hours of the morning LMW heparin injection, followed by immediate percutaneous coronary intervention (PCI) in 132 patients (28%). PCI was performed without any additional bolus of unfractionated/LMW heparin and without coagulation monitoring. Anti-Xa activity at the time of catheterization was 0.98±0.03 IU/mL, was &gt;0.5 IU/mL in 97.6% of patients, and did not relate to the LMW heparin injection-to-catheterization time. There were no in-hospital abrupt closures or urgent revascularizations after PCI. The death/myocardial infarction rate at 30 days was 3.0% in the PCI group (n=132) but 6.2% in the whole population (n=451) and 10.8% in the patients not undergoing catheterization (n=158). The 30-day major bleeding rate was 0.8% in the PCI group, which was comparable to that of patients without catheterization (1.3%). Conclusions —PCI within 8 hours of the last enoxaparin subcutaneous injection seems to be safe and effective. The safety of subcutaneous LMW heparin in combination with platelet glycoprotein IIb/IIIa blockade awaits further study.
Thalassemia Syndromes
Authors: Paul A. Marks
Journal: New England Journal of Medicine (1966)

THE thalassemia syndromes, as the phrase implies, are a group of entities. It is now recognized that the clinical picture that one associates with thalassemia can arise from a variety of inherited disorders in hemoglobin formation. The unifying aspect of this problem from the laboratory point of view is a partial or complete depression in the formation of one of the hemoglobin polypeptide chains.I shall first consider in general terms the major types of thalassemia and then discuss recent studies that are leading to an understanding of the nature of the genetically determined defect in the β type of . . .
BALB/c Mice Show Impaired Hepatic Tolerogenic Response Following AAV Gene Transfer to the Liver
Authors: Ekaterina Breous, Suryanarayan Somanathan, James M Wilson
Journal: Molecular Therapy (2010)

Following adeno-associated virus (AAV) gene transfer to the liver, both C57BL/6 and BALB/c mice show long-term expression of nonself transgene antigens along with the absence of a transgene-specific immune response. However, in this study, we report that despite the equal ability to induce T-cell tolerance to vector-encoded antigens, the underlying mechanisms are entirely different in these two strains. We have previously shown that in C57BL/6 mice, cytotoxic T lymphocyte (CTL) responses to systemic AAV-delivered antigens are suppressed by combined actions of hepatic regulatory T cells (Tregs), Kupffer cells, and hepatic suppressive cytokines. In stark contrast, our present findings reveal that such tolerogenic response is not induced in the liver of BALB/c mice systemically administered with AAV. As a result, these mice fail to suppress a transgene-specific CTL response induced by a strong immunogenic challenge and express dramatically reduced levels of AAV-encoded antigen. Interestingly, there was active B-cell tolerance to the transgene antigen, which was mediated by splenic Tregs. We conclude that lack of tolerance induction in the liver renders BALB/c mice susceptible to CTL-mediated clearance of transduced hepatocytes.
The damaging punch.
Authors: J Atha, M R Yeadon, J Sandover, K C Parsons
Journal: BMJ (1985)

The mechanical properties of a boxing punch have been determined using several techniques. The results are consistent with the medical consequences of boxing discussed in the report of the Board of Science and Education Working Party on boxing. Data were gathered from a world ranked British professional heavyweight, Frank Bruno, as he punched an instrumented, padded target mass suspended as a ballistic pendulum. Within 0.1 s of the start the punch had travelled 0.49 m and attained a velocity on impact of 8.9 m/s. The peak force on impact of 4096N (0.4 ton), attained within 14 ms of contact, represents a blow to the human head of up to 6320N (0.63 ton). The transmitted impulse generated an acceleration of 520 m/s2 (53 g) in the target head. For comparison an equivalent blow would be delivered by a padded wooden mallet with a mass of 6 kg (13 lbs) if swung at 20 mph.
A STUDY OF THE PROTEOLYTIC FERMENTS OF THE LARGE LYMPHOCYTES IN A CASE OF ACUTE LEUKÆMIA
Authors: Warfield T. Longcope, J. L. Donhauser
Journal: The Journal of Experimental Medicine (1908)

The leucocytes of the blood of normal individuals and of patients showing a marked polymorphonuclear leucocytosis contain enzymes capable of digesting coagulated blood serum in neutral, alkaline or acid solutions. The cells in pus that is composed principally of polymorphonuclear leucocytes and the leucocytes of the circulating blood in myelogeneous leukæmia contain similar proteolytic enzymes, which act best when the reaction is alkaline. The leucocytes of the circulating blood and of the enlarged lymph nodes from a case of large cell, acute, lymphatic leukæmia contain proteolytic enzymes that act qualitatively in much the same way as the leucocytes of pus and as the white corpuscles of the blood in myelogenous leukæmia. These large lymphocytes in acute lymphatic leukæmia can be differentiated biologically from the small lymphocytes in chronic lymphatic leukæmia which possess no proteolytic enzymes, and from the large endothelioid cells of the hyperplastic lymph glands which are proteolytic only in the presence of acid. These results seem to show that the large cells of the so-called acute lymphatic leukæmia are not true lymphocytes, but are nearly related to the granular myelocytes and should probably be considered as the forerunners to these cells.
RNAi screen of the druggable genome identifies modulators of proteasome inhibitor sensitivity in myeloma including CDK5
Authors: Yuan Xiao Zhu, Rodger Tiedemann, Chang-Xin Shi, Holly Yin, Jessica E. Schmidt, Laura A. Bruins, Jonathan J. Keats, Esteban Braggio, Chris Sereduk, Spyro Mousses, A. Keith Stewart
Journal: Blood (2011)
Human diploid cell rabies vaccine. Effectiveness of immunization with small intradermal or subcutaneous doses
Authors: K. W. Bernard
Journal: JAMA (1982)

To determine antibody responses to small doses of human diploid cell rabies vaccine (HDCV), we determined rabies antibody titers in 124 volunteers who had been vaccinated with one of five primary preexposure regimens. In a sixth group of 47 persons previously vaccinated with duck embryo rabies vaccine (DEV), we evaluated the booster responses after a 0.1-mL dose of intradermal (ID) HDCV. Persons in all five groups undergoing primary immunization received three doses of vaccine, one each on days 0, 7, and 28. The dose and route of vaccination for the five groups included 1 mL intramuscular (IM), 0.1 mL ID (two subgroups), 0.1 mL subcutaneous (SC), and 0.25 mL SC. Adequate titers developed in all persons, irrespective of the route or quantity of vaccine. The geometric mean titers (IU/mL) on day 49 in those receiving primary regimens were 12.87 (1.0 mL IM), 7.44 (0.1 mL ID by syringe), 3.05 (0.1 mL by jet injector), 3.17 (0.1 mL SC), and 6.47 (0.25 mL SC). Titers on day 90, while lower, were still acceptable. Adequate antibody titers developed in all persons previously vaccinated with DEV after a single 0.1-mL ID dose of HDCV; however, higher titers developed at day 7 in those who had shown an adequate response to DEV in the past. Results of this study suggest that HDCV may be used ID or SC for primary preexposure rabies prophylaxis and ID for booster immunization.
Exhibition hopes to give <i>Gray’s Anatomy</i> artist his proper due
Authors: Wendy Moore
Journal: BMJ (2008)

When two friends, both young surgeons at St George’s Hospital, London, joined forces in 1855 to create a practical and affordable anatomy textbook for students they could have had little idea of the eventual success of their project. Celebrating its 150th anniversary this year, with its 40th edition about to roll off the press, Gray’s Anatomy has become the world’s longest running and probably best known anatomical work.

Yet, although the book’s author, Henry Gray, has become a household name, its illustrator, Henry …
Polio vaccine plans may run into problems in Nigeria
Authors: A. Raufu
Journal: BMJ (2003)

Plans by the World Health Organization to vaccinate against poliomyelitis in Nigeria to eradicate the condition there by the end of the year could run into a major hurdle.

The Supreme Council for Sharia, one of the respected Muslim organisations in the predominantly Muslim region of northern Nigeria, has asked the government to halt the immunisation programme, claiming it has evidence to show that the vaccine contains anti-fertility substances.

The secretary general of the Supreme Council for Sharia in …
The Fossil Evidence for Human Evolution: An Introduction to the Study of Paleoanthropology
Authors: Charles G. Roland
Journal: JAMA (1964)

In a short survey for nonspecialists, the reader expects to find sharp comers rounded off, controversies glibly evaded or ignored. Professor LeGros Clark has no such intention. On the contrary, he has written a highly stimulating book which not only summarizes the cogent material, but also expresses some unorthodox theories.  We are usually taught that the evolution of ground-living forms in the ancestry of man resulted from adaptations secondary to the abandonment of arboreal life. Paradoxically, the author suggests that these adaptations were concerned with an attempt to retain arboreal life. For in regions undergoing gradual deforestation, they would make it possible to cross intervening grasslands in order to pass from one restricted and shrinking wooded area to another.  Emphasizing that the origin of the Hominidae is still conjectural, LeGros Clark hypothesizes that the gradational series of types—modern Homo sapiens , Early Mousterian and Acheulian man, Homo erectus (Pithecanthropus) , and Australopithecus
Some Characteristics of Certain Reflexes Which Modify the Circulation in Man
Authors: LYSLE H. PETERSON
Journal: Circulation (1950)

Records are presented which have been obtained from man by direct intra-arterial catheterization and electrocardiography. These records have been selected (1) because they offer evidence for the validity of Starling's law in intact man and (2) because they demonstrate that when the heart is influenced by activity of the so-called "intrinsic" reflexes these manifestations of Starling's law are modified. It appears from these types of data that ventricular activity may be directly affected independently of influences upon the pacemakers of the heart.