tbuckley/cabot-search huggingface dataset:
Nurses: the point of no return.
Authors: J Salvage
Journal: BMJ (1990)

deleted and surveillance maintained by other systems -for example, through general practitioner reporting in the Royal College of General Practitioners Birmingham research unit scheme, laboratory reporting by medical microbiologists of data collected in England and Wales by the Public Health Laboratory Service Communicable Disease Surveillance Centre, local hospital and clinic reports, and special surveil- lance schemes.Other diseases could be included, such as legionnaires' disease, ornithosis, and Q fever, because these may need immediate preventive action.Notification should remain the clinician's responsibility.It should be made on suspicion of the diagnosis and within 48 hours on a modernised form or by electronic means, although clinicians should telephone the consultant in communicable disease control if immediate investigation and control measures are required.The substantial increase in the fee in 1984 did not seem to encourage more complete notification,4 the system is costly to administer, and it could be argued that notification is part of a clinician's duty to the public health.If the fee were replaced by regular provision of information to clinicians on prevalent infections and control measures then such feedback would be more likely to improve the ascertain-
WHAT CAN BE DONE IN CEREBRAL SURGERY? REMARKS BASED CHIEFLY UPON PERSONAL EXPERIENCE IN TWENTY-THRE CASES.Read before the Kansas City Academy of Medicine, November 28, 1891
Authors: EMORY LANPHEAR
Journal: JAMA (1891)

To those unfamiliar with recent advances in surgery of the brain, my paper may be something of a surprise because of the radical changes which have occurred in this department of operative surgery within the past few years; in fact, I doubt not there are some who will contend that we are too aggressive—that we invade the cranium with too much impunity. But from a careful study of twenty-three cases upon which I have operated (a series of cases presenting two deaths and twenty-one recoveries), and a review of recent contributions to the literature of the subject, I firmly believe that we have not yet awak ened to the possibilities in operative surgery of the nervous system. Bremer, of St. Louis, says: "Owing to the comparative safety afforded by asepsis, many more skulls are opened than the state of our knowledge of the brain, its physiology and pathology, warrant." Perhaps
The Cook Report: assisted conception
Authors: A. Ong, B. Josephs, A. Taylor, H. Annan, P. Speck, P. Gugenheim
Journal: BMJ (1991)

Licensed Victuallers' Association has openly con- demned the proposals.It is difficult to see, therefore, how our recom- mendations could be regarded as biased by a concern for the sensitivity of our sponsors.Though we have not exactly bitten the hand that feeds us, we have probably given it something of a nip.
An Epidemic of Peripheral Neuritis amongst Beer Drinkers in Manchester and District
Authors: E. S. Reynolds
Journal: BMJ (1900)

I should say that between June and November the patient had gone into the surgical wards in order to have an operation, but that Mr. Anderson had hesitated to undertake one.Operation.-However,Mr. Anderson and I consulted on the case, and thouglht that section of one or more roots might relieve his sufferings if it could not cure the disease.The serious nature of the operation having, therefore, been fully explained both to the patient and his family, on November 26th Mr. Anderson did a laminectomy and exposed the cord at the level of the sixth, seventh, and eiglltlh dorsal roots.Notlhing abnormal was seen on the cord or its membranes, but the eightlh left posterior root was distinctly thicker than the others.Pieces were cut out from the seventh and eightlh roots on botlh sides, those from the eighth roots being placed in osmic acid for microscopical examination.The result of the operation was not satisfaotory, as, in spite of antiseptic syringing, pus formed in thc wound, fever set in, and six days later the patient died.
Incidence of metabolic bone disease in rheumatoid arthritis and osteoarthritis.
Authors: K C Ng, P A Revell, M Beer, B J Boucher, R D Cohen, H L Currey
Journal: Annals of the Rheumatic Diseases (1984)

Bone biopsy specimens from the iliac crest were obtained during surgical operations from 45 patients with rheumatoid arthritis (RA) and 41 with osteoarthritis (OA). Control material was obtained from 20 cases of sudden death due to cardiovascular disease. By both conventional histology and image analysis techniques about a quarter of all patients showed some osteoporosis. This was equally common among the OA and RA patients. It was more common among those with transparent skin and those taking corticosteroids. The only case showing mild osteomalacia suffered from OA. No gross differences were apparent between the groups in relation to plasma biochemical studies, diet, or exposure to sunlight. These results are in striking contrast to the high incidence of osteomalacia in RA reported from the west of England; moreover they do not confirm reports of hypercalcaemia among rheumatoid subjects. We conclude that the differences regarding osteomalacia are due to selection of cases. We find no evidence that osteomalacia is specifically associated with RA.
The Canon of Medicine
Authors: G. Koh
Journal: BMJ (2009)

The Canon of Medicine is one of almost 450 treatises written by the Persian polymath Ibn Sīnā (better known in Europe as Avicenna, c 980-1037). The modern world has called him an astronomer, chemist, logician, mathematician, physicist, poet, and teacher; but to the Muslim world he was “prince of physicians” and pinnacle of the 10th century Persian renaissance.

Ibn Sīnā was born to a scholarly Persian family in Bukhara (a city on the Silk Road and capital of the Samanid empire). He had memorised the Quran by age 10 and mastered astronomy, law, mathematics, and philosophy before beginning to study medicine at 16. He …
AIDS, Autopsies, and Abandonment
Authors: Stephen J. Sarewitz
Journal: JAMA (1989)

To the Editor.—  I  several comments about the article by Drs Ratzan and Schneiderman 1 entitled AIDS, Autopsies, and Abandonment.  They state that pathologists  an obligation to perform necropsies on patients with acquired immunodeficiency syndrome analogous to the obligation of endoscopists and surgeons to perform indicated and necessary operations on AIDS  The logic behind this notion escapes me. It is evident to me that performing an autopsy does not lessen the suffering of the deceased patient. An individual autopsy may contribute an increment of knowledge about disease that may help future patients. In some cases, the performance of an autopsy may ease the suffering of the deceased patient's family, but sometimes the reverse is true. By no stretch of the imagination do these benefits carry the same weight as do procedures performed to help a sick patient.  The authors state that physicians have knowingly made a risky
Serum Androgens As Prognostic Biomarkers in Castration-Resistant Prostate Cancer: Results From an Analysis of a Randomized Phase III Trial
Authors: Charles J. Ryan, Arturo Molina, Jinhui Li, Thian Kheoh, Eric J. Small, Christopher M. Haqq, Russell P. Grant, Johann S. de Bono, Howard I. Scher
Journal: Journal of Clinical Oncology (2013)

In the phase III study COU-AA-301, abiraterone acetate (AA) plus prednisone (P) prolonged overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) after docetaxel administration. In this article, we investigate the relationship between baseline serum androgen (SA) levels and OS.COU-AA-301 is a randomized, double-blind study of AA (1,000 mg every day) plus P (5 mg by mouth twice daily; n = 797) versus P alone (n = 398). Randomization was stratified by Eastern Cooperative Oncology Group performance status (0 to 1 v 2), pain (Brief Pain Inventory-Short Form over past 24 hours: 4 to 10, present; v 0 to 3, absent), prior chemotherapy (1 v 2), and progression (prostate-specific antigen v radiographic). Association of baseline SA (testosterone, androstenedione, dehydroepiandrosterone sulfate), was measured by ultrasensitive liquid-liquid extraction or protein precipitation and two-dimensional liquid chromatography coupled to mass spectrometry, with OS determined by bivariate and multivariable Cox models. OS was examined with SA as greater than median and less than or equal to the median.Median survival increased with each quartile increase in testosterone level regardless of treatment arm. SA levels at baseline strongly associated with survival (P < .0001) in bivariate and multivariable analyses. Longer survival was observed for patients with SA above median compared with below median in both the AA and P arms (eg, testosterone, AA; hazard ratio, 0.64; 95% CI, 0.53 to 0.77; P < .0001). Treatment with AA led to longer survival versus P alone in the above- or below-median group for all androgens.SA, measured with a novel ultrasensitive assay in COU-AA-301, is prognostic for OS and may be useful for risk stratification in mCRPC clinical trials.
PSYCHIATRIC ILLNESS IN HOSPITALIZED CATHOLIC RELIGIOUS
Authors: ROBERT J. McALLISTER, ALBERT J. VANDER VELDT
Journal: American Journal of Psychiatry (1965)

Case histories of 200 Catholic religious, 100 priests and 100 nuns, consecutively discharged from a private psychiatric hospital, have been studied in relation to more than 50 variables. The case histories of 100 laymen and 100 laywomen, consecutively discharged from the same hospital, have been used for comparison. Questionnaires administered to 100 seminarians and 100 sisters without psychiatric illness have been used for additional comparative data. It has been found that diagnoses, major symptomatology, and age of onset of illness differed considerably between the two patient groups. Socio-economic back-ground, school achievement, and parental influence also differed significantly. In these factors, the lay patients more closely resembled the non-patient religious group than the religious patients. The duration of hospitalization and patient attitude toward treatment differed significantly between the religious and lay patients. Psychiatric evaluation and treatment of religious candidates could do much to alleviate the unhappiness that results from a commitment which creates conflicts. A healthier attitude toward psychiatry on the part of religious superiors could do much to alleviate the guilt and the scorn incurred by those who need such care.
Dendritic cell subsets in human bronchoalveolar lavage fluid after segmental allergen challenge
Authors: K. Bratke, M. Lommatzsch, P. Julius, M. Kuepper, H.-D. Kleine, W. Luttmann, J Christian Virchow
Journal: Thorax (2006)

Dendritic cells control pulmonary immune reactions. Characteristics of dendritic cells in human bronchoalveolar lavage fluid (BALF) after allergen challenge are unknown.7 patients with allergic asthma (median 23 years, range 19-25 years) underwent segmental challenge and were lavaged 10 min and 24 h after challenge. Dendritic cell subsets and surface markers in BALF and in peripheral blood were analysed using four-colour flow cytometry.Plasmacytoid dendritic cells (pDCs, median 0.06%, range 0.01-0.08%) and myeloid dendritic cells (mDCs, median 0.47%, range 0.27-0.87%) were detectable in BALF from control segments. CD1a-positive dendritic cells in BALF were identified as a subpopulation of mDCs. Both pDCs (median 0.56%, range 0.09-1.83%) and mDCs (median 1.82%, range 0.95-2.29%) increased significantly in BALF 24 h (p = 0.018 compared with the control segments for pDCs and mDCs), but not 10 min, after allergen challenge. The percentage increase in pDCs was higher than that of mDCs after allergen challenge, as reflected by an enhanced pDC:mDC ratio after allergen challenge. In peripheral blood, there was a significant decrease in mDCs (p = 0.038) and a trend to a decrease in pDCs (p = 0.068) 24 h after allergen challenge. Analysis of dendritic cell surface molecules showed that after allergen challenge, BALF dendritic cells have a less mature phenotype compared with BALF dendritic cells from control segments.Using a comprehensive strategy to analyse dendritic cell subsets in human BALF, we have shown for the first time that both myeloid and plasmacytoid dendritic cells accumulate in the airway lumen after allergen challenge in patients with asthma.
Impaired Elastic Properties of the Ascending Aorta in Newborns Before and Early After Successful Coarctation Repair
Authors: Manfred Vogt, Andreas Kühn, Daniela Baumgartner, Christian Baumgartner, Raymonde Busch, Martin Kostolny, John Hess
Journal: Circulation (2005)

Despite successful surgical correction, morbidity of patients with coarctation of the aorta is increased. It is well known that these patients have impaired elastic properties of the prestenotic arteries. To find out whether these abnormalities are primarily present or develop later, we studied 17 newborns before and early after surgical repair.Aortic wall stiffness index and distensibility were calculated using ascending and abdominal aortic diameters determined by M-mode echocardiography and noninvasive estimation of aortic pulse pressure in the right arm and leg. Seventeen patients with aortic coarctation (mean age, 20+/-26 days) were compared with 17 normal neonates (mean age, 13+/-7 days) preoperatively and postoperatively (10+/-6 days after surgery). Ascending aortic distensibility in patients was significantly reduced preoperatively (79+/-58 versus 105+/-36; P=0.03) and postoperatively (65+/-24 versus 105+/-36; P<0.005). Preoperative and postoperative ascending aortic stiffness index was higher in patients (preoperative, 5.2+/-4.4 versus 2.7+/-0.9; P=0.04; postoperative, 4.0+/-1.6 versus 2.7+/-0.9; P<0.005). Elastic properties of the descending aorta did not differ preoperatively or postoperatively compared with those in normal subjects.Elastic properties of the prestenotic aorta of patients with coarctation seem to be impaired primarily, even in neonates, and remain unchanged early after successful operation. Surgical correction does not resolve inborn pathology of the prestenotic aortic vascular bed.
Genetic Studies Provide New Insights Into Breast Cancer Biology and Treatment
Authors: Tracy Hampton
Journal: JAMA (2013)

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Clinical Impact of SPECT/CT With In-111 Biotin on the Management of Patients With Suspected Spine Infection
Authors: Elena Lazzeri, Paola Erba, Marzio Perri, Roberta Doria, Carlo Tascini, Giuliano Mariani
Journal: Clinical Nuclear Medicine (2009)

Early identification and localization of spine infection is necessary for adequate therapeutic strategy. To localize the precise site of infection we evaluated In-111 Biotin SPECT/CT versus planar and SPECT imaging.Seventy-two consecutive patients were enrolled and underwent SPECT/CT and planar imaging 2 to 4 hours post i.v. injection of In-111 Biotin. Final diagnosis was based on bacterial cultures and/or clinical/imaging follow-up for at least 1 year. We evaluated the diagnostic performance of planar, SPECT, and SPECT/CT In-111 Biotin scintigraphy.In-111 Biotin SPECT/CT and SPECT showed similar values of sensitivity (93.5% vs. 92.1%) and the same specificity (92.3%), planar imaging showed 80.4% of sensitivity and 69.2% of specificity. In 16 patients SPECT/CT correctly localized the infection site (bone, soft tissue, or both bone and soft tissue).SPECT/CT enhances the impact of In-111 Biotin scintigraphy on the clinical management of patients, allowing the exact site of infection to be localized to select the appropriate therapy.
Hypermelanocytic guttate and macular segmental hypomelanosis
Authors: W. Westerhof, K.P. Dingemans, R.F.H.J. Hulsmans
Journal: British Journal of Dermatology (2004)

We report two sisters, 27 and 30 years of age, with a cutaneous pigmentary anomaly, which seems to be a new entity. At the age of 26 years the elder sister developed an asymptomatic and persistent rash consisting of discrete, grouped, round to oval, guttate and nummular, hypopigmented macules, 0·2–5 cm in diameter. The distribution of the lesions was unilateral. They were located on the right side of the thorax with a moderately sharp demarcation in the mid‐line and ran in a segmental distribution over the right arm, hand and fingers. Microscopic examination of lesional skin scrapings was negative for fungi. Examination with Wood's light accentuated the lesions from the surrounding normal skin. The younger sister had experienced identical, mostly guttate, skin lesions for many years, which at examination were distributed on all extremities and buttocks, and to a lesser degree on the trunk, but here in a segmental distribution. Histological examination (Masson–Fontana staining) of lesional skin of both sisters was identical. A slightly thinned epidermis and a marked decrease in pigmentation of the epidermal basal layer was seen. Electron microscopic examination of lesional skin showed an overall linear increase of morphologically and cytologically normal melanocytes just above the epidermal basal membrane. At many places the density of melanocytes was so high that the keratinocytes were displaced from the basal layer. The melanocytic dendrites extended into the suprabasal layer. The keratinocytes of lesional skin showed a decreased number of melanosomes. It is paradoxical that a hypomelanotic macule shows a histological picture of an increase in normal functioning melanocytes. In all probability a deficient melanosome transfer is responsible for this unexpected phenomenon.
CASES OF SPINAL DISEASE
Authors: S. Hare
Journal: BMJ (1854)

ORIG0NAL ONA MUWICATION8.1121 _ , d ko dit d over folds of lint, was i ata shd di e *om her mouth and nostrils.ing the inhation of the apour, the tourniquet was ajusted ove the femral arter7.It wa secure tightly ~a few seconds, to ascertain if its presure comd ed e ption of the artery; but it was immediately after
Squash ball to eye ball: the likelihood of squash players incurring an eye injury.
Authors: G V Barrell, P J Cooper, A R Elkington, J M Macfadyen, R G Powell, P Tormey
Journal: BMJ (1981)

The records of the 118 patients treated as Southampton Eye Hospital during 1978-9 for injuries incurred while playing squash, badminton, tennis, table tennis, cricket, and football show that for squash the main cause of eye injury was the player being hit by the ball. Severe eye injuries--those requiring treatment as an inpatient--were rare but much more frequent than such injuries in other sports. Less serious injuries--those requiring treatment as an outpatient--were also rare, with a frequency comparable with that of similar injuries in football and badminton. Squash players are most unlikely to incur an eye injury, but should this occur it has far-reaching consequences both in the short and the long term. Each individual player must weigh these chances and consequences against the possible inconvenience of using some form of eye protection.
Complementary DNA for the folate binding protein correctly predicts anchoring to the membrane by glycosyl-phosphatidylinositol.
Authors: S W Lacey, J M Sanders, K G Rothberg, R G Anderson, B A Kamen
Journal: Journal of Clinical Investigation (1989)

Membrane bound and soluble forms of a high-affinity folate binding protein have been found in kidney, placenta, serum, milk, and in several cell lines. The two forms have similar binding characteristics for folates, are immunologically cross-reactive and based upon limited amino acid sequence data, are nearly identical. Based upon pulse-chase experiments, a precursor-product relationship has been suggested. The membrane form has been shown to mediate the transport of folate in cells grown in physiological concentrations of folate. A function for the soluble form has not yet been identified. We constructed a cDNA library from a human carcinoma cell line, Caco-2, which expresses the membrane form abundantly. The library was screened and a near full-length cDNA for the folate binder was isolated. Transfection of COS cells with the cDNA inserted in an expression vector resulted in marked overexpression of a membrane-associated folate binder as assessed by direct binding of radiolabeled folate and by indirect immunofluorescence. The deduced amino acid sequence is not consistent with a typical membrane spanning domain but rather with a signal for anchoring via a glycosyl-phosphatidylinositol linkage. Release of the binder with a phosphatidylinositol-specific phospholipase C strongly supports this hypothesis.
Social Disparities in Nitrate-Contaminated Drinking Water in California’s San Joaquin Valley
Authors: Carolina Balazs, Rachel Morello-Frosch, Alan Hubbard, Isha Ray
Journal: Environmental Health Perspectives (2011)

Research on drinking water in the United States has rarely examined disproportionate exposures to contaminants faced by low-income and minority communities. This study analyzes the relationship between nitrate concentrations in community water systems (CWSs) and the racial/ethnic and socioeconomic characteristics of customers.We hypothesized that CWSs in California's San Joaquin Valley that serve a higher proportion of minority or residents of lower socioeconomic status have higher nitrate levels and that these disparities are greater among smaller drinking water systems.We used water quality monitoring data sets (1999-2001) to estimate nitrate levels in CWSs, and source location and census block group data to estimate customer demographics. Our linear regression model included 327 CWSs and reported robust standard errors clustered at the CWS level. Our adjusted model controlled for demographics and water system characteristics and stratified by CWS size.Percent Latino was associated with a 0.04-mg nitrate-ion (NO3)/L increase in a CWS's estimated NO3 concentration [95% confidence interval (CI), -0.08 to 0.16], and rate of home ownership was associated with a 0.16-mg NO3/L decrease (95% CI, -0.32 to 0.002). Among smaller systems, the percentage of Latinos and of homeownership was associated with an estimated increase of 0.44 mg NO3/L (95% CI, 0.03-0.84) and a decrease of 0.15 mg NO3/L (95% CI, -0.64 to 0.33), respectively.Our findings suggest that in smaller water systems, CWSs serving larger percentages of Latinos and renters receive drinking water with higher nitrate levels. This suggests an environmental inequity in drinking water quality.
PRACTICAL INTEGRATIVE DIAGNOSTIC STRATEGY FOR PATIENTS WITH SUSPECTED CORONARY ARTERY DISEASE: INSIGHT FROM 1,286 PATIENTS UNDERGOING BOTH ANATOMICAL AND FUNCTIONAL TESTS
Authors: Hack-Lyoung Kim, Yong-Jin Kim, Seung-Pyo Lee, Jin-Chul Paeng, Hyung-Kwan Kim, Whal Lee, Goo-Yeong Cho, Dong-Ju Choi, Dae-Won Sohn
Journal: Journal of the American College of Cardiology (2013)