tbuckley/cabot-search huggingface dataset:
Yesterday's heroes
Authors: Domhnall Macauley
Journal: British Journal of Sports Medicine (2000)

Warm downA parting gift.Some memorable papers that made us smile.Astrology is not our strongest suit and, as scientists, our first response was that perhaps the postman had got it wrong (page 465).Strange, unusual, intuitively, and intellectually challenging.But fascinating.In the scientific world of sport, dominated by physiologists, biochemists, pharmacists, and even geneticists, the idea that performance could be related in some way to the path of the moon and the stars sounds daft at first.Can you imagine the implications?Pregnancies planned to coincide with astrological events.Multi million pound transfer deals determined by heavenly bodies.Never mind your goal scoring record, tell us your star sign.Fishing injuries.It's sport, it's injury-yes, it's the right journal.Looking for a reviewer, no one came to mind immediately.Nothing in the medical literature was even close.The paper that nearly got away (page 459).We finally found two reviewers; a kilted colleague on a Scottish island, and a Gaelic speaking part time GP in the west of Ireland.So you don't think it is relevant to our journal?Wait until you try removing a fishhook.
US effort to cut caesarean section rate may be harmful
Authors: S. Gottlieb
Journal: BMJ (1999)

Efforts to reduce the number of caesarean births in the United States may be leading to an increased number of serious injuries to newborn infants and putting some mothers at risk, according to four obstetricians at Harvard Medical School.

The doctors, who voice their concern in an editorial in the New England Journal of Medicine (1999;340:54-7), call for a moratorium on efforts to reduce the number of caesarean sections performed in the …
Refugees from Indochina
Authors: Robert P. Aduan, Mary Mccutcheon, Maria Eitz, Philip Sanger
Journal: Annals of Internal Medicine (1980)

Letters1 February 1980Refugees from IndochinaROBERT P. ADUAN, M.D., MARY MCCUTCHEON, R.N., MARIA EITZ, PHILIP SANGER, M.D.ROBERT P. ADUAN, M.D.Search for more papers by this author, MARY MCCUTCHEON, R.N.Search for more papers by this author, MARIA EITZSearch for more papers by this author, PHILIP SANGER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-2-266_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In July 1979 President Carter announced that 14 000 refugees from Indochina would be accepted monthly for resettlement in the United States. Since 1975 about 225 000 refugees from Indochina have settled in the United States. The Center for Disease Control is responsible for the medical screening of refugees while they are still abroad and for the inspection of refugees upon arrival at U.S. ports of entry. The Center has estimated that 1% to 2% of refugees who have arrived in the United States during 1979, and have been examined, have been found to have active tuberculosis...References1. . Health status of Indochinese refugees. Morbid Mortal Weekly Rep. 1979;28:385-90, 395-8. Google Scholar2. . Screening of Indochinese refugees—Ottawa, Ontario. Can Dis Weekly Rep. 1979;5:157-62. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySecular change in birthweight among southeast Asian immigrants to the United States.Health problems among Indochinese refugees.Indochinese Refugees and Infectious DiseaseRICHARD A. GOODMAN, M.D., TIMOTHY J. DONDERO JR., M.D., MYRON G. SCHULTZ, D.V.M., M.D., JOSEPH F. GIORDANO, DONALD R. HOPKINS, M.D.Tuberculosis in Indochinese RefugeesKENNETH E. POWELL, M.D., RICHARD A. GOODMAN, M.D., LAURENCE S. FARER, M.D. 1 February 1980Volume 92, Issue 2_Part_1Page: 266-266 Issue Published: 1 February 1980 PDF DownloadLoading ...
Lipoprotein(a) concentration and risk of atherothrombotic disease
Authors: W. Y. Craig
Journal: JAMA (1995)

<h3>To the Editor.</h3> —In their article, Dr Ridker and colleagues<sup>1</sup>reported that there was no prospective association between lipoprotein(a) [Lp(a)] concentration and the risk of stroke. The authors summarized briefly the results of prior prospective studies of Lp(a) as a risk factor for coronary artery disease; however, certain points raised in that discussion require clarification. Namely, two studies that used the arbitrary nomenclature "apo (a)" for apolipoprotein (a) as opposed to "Lp(a)" were addressed separately. With one exception,<sup>2</sup>all studies to date have detected Lp(a) using immunoassays directed against apo(a). For example, Ridker et al<sup>1</sup>refer to "Lp(a)" and Wald et al<sup>3</sup>in the article cited by Ridker et al refer to "apo(a)"; however, both groups used the Biopool ELISA (enzyme-linked immunosorbent assay). Thus, it is neither necessary nor appropriate to dichotomize studies based on differences in nomenclature. Therefore, among prior prospective studies of Lp(a) and
Comment on d’Emden. Do the New Threshold Levels for the Diagnosis of Gestational Diabetes Mellitus Correctly Identify Women at Risk? Diabetes Care 2014;37:e30
Authors: Boyd E. Metzger, Alan R. Dyer
Journal: Diabetes Care (2014)

In this issue, d’Emden (1) challenges the plasma glucose level diagnostic thresholds for gestational diabetes mellitus (GDM) recommended by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) (2). In particular, it is asserted that the rate of large-for-gestational-age (LGA) children (birth weight >90th percentile) in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study cohort (3) is lower when the 1-h and/or 2-h threshold as a single value is equal to or greater than a threshold value than is the case when the fasting plasma glucose (FPG) threshold is met or exceeded; in this case, the odds ratio (OR) of 1.75 is not met or exceeded. It is claimed that …
Tobacco: are we all to blame?
Authors: Jonathan H Burton
Journal: BMJ (2006)

Case reports of suspected adverse drug reactions Case reports were dismissed too quicklyEditor-The main difference between the replications by Loke et al of Venning's studies from the 1980s and the original is the evidence that is accepted as further follow-up. 1 Loke et al mention that 56 of 63 case reports on adverse reactions were cited at least once but accept only nine instances as valid follow-up: attempts at proof of mechanisms or controlled studies.However, unexpected adverse effects are by definition due to an unknown mechanism, and many established adverse effects still escape elucidation after years.Moreover, further accumulation of anecdotal reports can be sufficient evidence.A 10 year tally of 22 drugs that were withdrawn from the market showed that 18 were prompted by case reports and only four by a controlled study; for at least 13 the case reports proved sufficient reason for withdrawal. 2 A highly unusual event that is repeatedly reported in a recently marketed drug, in the absence of publicity, points to an exceedingly high relative risk, a good argument for cause and effect. 3 Moreover, these risks will be picked up spontaneously. 4 5 Apart from the nine instances of follow-up that were accepted by Loke et al, 15 datasheets were amended and seven BNP drug monographs changed.So, even with some overlap, close to half of the case reports were somehow sufficiently noteworthy to have had consequences.Given the small sample size, this is not far from Venning's original.It is a pity that Loke et al do not make all follow-up more explicit for all 56 instances that followed the 63 reports.Their overall conclusion that lack of follow-up means that case reports are of limited value is a non-sequitur.It shows that a more consistent scheme of hypothesistesting studies by industry, government, or third parties is needed instead of the current haphazard approach to drug safety.Such publications may alert and help clinicians in recognising potential adverse events in their patients.Often there is no other way of discovering something unusual.The record of systematic-that is, controlledpostmarketing surveillance in detecting unexpected adverse effects remains surprisingly poor.
Canadian woman ignores court to claim right to die
Authors: J Roberts
Journal: BMJ (1994)

<h3>Background</h3> New antibiotics for gonorrhea are needed due to the emergence of resistance to extended-spectrum cephalosporins in <i>Neisseria gonorrhoeae</i> (<i>Ng</i>). We recently established the 17β-estradiol mouse model of gonococcal lower genital tract infection for testing antibiotics that utilize free time above MIC as the pharmacokinetic (PK) driver to predict efficacy. We further established the mouse model for antibiotic testing by defining the <i>in vivo</i> efficacy of ciprofloxacin (CIP), an antibiotic that uses the free area under the curve over MIC (<i>f</i>AUC/MIC). <h3>Methods</h3> Lower genital tract infection with <i>Ng</i> strain FA1090 was established in female mice using published methods for two days, after which increasing oral doses of CIP (or controls) were administered (n = 10–20 mice/group) and infection was quantified for 8 days. Plasma drug levels from uninfected mice were measured after administration of similar doses of CIP, and PK parameters (modeled using WinNonlin software) were correlated with observed efficacy. <h3>Results</h3> Single oral doses ranging from 5 to 60 mg/kg CIP showed significant activity against strain FA1090, with the highest doses (15, 30, and 60 mg/kg) clearing 100% of infections within 8 days; these correspond to predicted <i>f</i>AUC/MICs of 66–264. The 60 mg/kg dose cleared infection in all mice within 48 h, which we defined previously as the endpoint in the model that best correlates with<i> in vivo</i> exposures required for successful CRO/CFX treatment regimens. <h3>Conclusion</h3> The gonorrhea mouse model shows a dose-dependent response for CIP against a CIP<sup>S</sup> strain with a dose of 60 mg/kg required to clear infection in 48 hrs. PK modeling suggests that achieving exposures necessary for effective treatment of CIPR strains (mic ≥1 µg/ml) would be challenging. These data that establish PK/PD correlations for CIP - with a <i>f</i>AUC/MIC driver- further strengthens the usefulness of this mouse model to test novel antimicrobial compounds against gonorrhea. <h3>Disclosure</h3> No significant relationships.
Dipyridamole-Induced Myocardial Ischemia-Reply
Authors: Theodore N. Keltz
Journal: JAMA (1987)

<h3>In Reply.—</h3> In response to Dr Ranhosky's comments, we agree that our report does not<i>prove</i>that dipyridamole caused the episodes of ischemia observed; however, we feel that the general medical community should be aware that dipyridamole has been demonstrated to induce myocardial ischemia in animals and man, as referenced in our report. Based on our observations, we identified a small group of patients at particular risk—notably, those with unstable angina, multivessel coronary disease, and epicardial coronary collaterals. Dr Ranhosky focuses on the incidence of myocardial infarction and death but not of ischemic episodes in "two large studies." His statement that "the incidence of severe myocardial ischemic episodes after... administration of dipyridamole is low" is unsupported. The first study has apparently not been published. The second study is completely misrepresented. Homma et al administered 300 mg of oral dipyridamole to 100 patients; fully 25% of the patients had chest pain
A CONSIDERATION OF THE STONELESS GALLBLADDER
Authors: EVARTS A. GRAHAM
Journal: JAMA (1934)

Several writers have called attention to the frequency of unsatisfactory results after cholecystectomy on patients whose gallbladders showed a minimal amount of change from the normal condition (Whipple, 1 Muller, 2 Judd, 3 Stanton 4 and others). The observation, therefore, that surgical results in the stoneless gallbladder, on the whole, are not so satisfactory as in those cases in which gallstones are present is not by any means new.  In most other conditions the idea has gained ground that one should attack a disease early in order to obtain the most satisfactory therapeutic results. Alvarez 5 has even suggested that the same principle holds true in cases of cholecystitis. There is some reason to think, however, that this principle does not hold for diseases of the biliary tract. Indeed, if one were to be guided only by a table of comparative results obtained by cholecystectomy in cases of minimal pathologic
Recruitment, Retention, and Follow-up of Graduates of a Program to Increase the Number of Family Physicians in Rural and Underserved Areas
Authors: Howard K. Rabinowitz
Journal: New England Journal of Medicine (1993)

To help address the geographic and specialty maldistribution of physicians, Jefferson Medical College initiated the Physician Shortage Area Program (PSAP) in 1974. This unique program, which combines a selective medical school admissions policy with a special educational program, has been shown to be successful in increasing the number of family physicians in rural and underserved areas, but it is not known whether they remain in this type of practice.Graduates of the PSAP were tracked longitudinally and compared with their non-PSAP classmates. Information was obtained about the retention of family physicians in rural areas and areas with a physician shortage over the previous five years, the geographic and specialty choices of more recent graduates, and the recruitment of applicants into the program.Of the 47 PSAP graduates from the classes of 1978 through 1981, reported on earlier, the number who combined a career in family medicine with practice in a rural area or one with a physician shortage remained unchanged, although there was substantial attrition among non-PSAP graduates practicing family medicine in rural (32 percent) and underserved (40 percent) areas. Among the 101 PSAP graduates of the classes of 1982 through 1986, the results were similar to those for the first four classes. Overall, PSAP graduates from the classes of 1978 through 1986 were approximately four times as likely as non-PSAP graduates to practice family medicine (55 percent vs. 13 percent), to practice in a rural area (39 percent vs. 11 percent), and to practice in underserved areas (33 percent vs. 8 percent). They were approximately 10 times more likely to combine a career in family medicine with practice in a rural (26 percent vs. 3 percent) or underserved (23 percent vs. 2 percent) area. Overall, 85 percent of PSAP graduates were either practicing a care specialty or practicing in a rural or small metropolitan area or one with a shortage of physicians. In parallel with national trends, the number of applicants and matriculants to the program decreased during the past decade, so that the percentage of available places filled decreased from 97 percent to 33 percent. However, there has been a recent increase in the number of applicants and matriculants.The results of this study indicate that the PSAP was successful in increasing the number of family physicians in rural and underserved areas as well as in retaining them. This suggests that medical schools can have a substantial influence on the distribution of physicians according to specialty choice and the geographic location of their practices, principally through admission criteria.
Plasma and muscle free carnitine deficiency due to renal Fanconi syndrome.
Authors: I Bernardini, W B Rizzo, M Dalakas, J Bernar, W A Gahl
Journal: Journal of Clinical Investigation (1985)

Plasma and urine free and acyl carnitine were measured in 19 children with nephropathic cystinosis and renal Fanconi syndrome. Each patient exhibited a deficiency of plasma free carnitine (mean 11.7 +/- 4.0 [SD] nmol/ml) compared with normal control values (42.0 +/- 9.0 nmol/ml) (P less than 0.001). Mean plasma acyl carnitine in the cystinotic subjects was normal. Four subjects with Fanconi syndrome but not cystinosis displayed the same abnormal pattern of plasma carnitine levels; controls with acidosis or a lysosomal storage disorder (Fabry disease), but not Fanconi syndrome, had entirely normal plasma carnitine levels. Two postrenal transplant subjects with cystinosis but without Fanconi syndrome also had normal plasma carnitine levels. Absolute amounts of urinary free carnitine were elevated in cystinotic individuals with Fanconi syndrome. In all 21 subjects with several different etiologies for the Fanconi syndrome, the mean fractional excretion of free carnitine (33%) as well as acyl carnitine (26%) greatly exceeded normal values (3 and 5%, respectively). Total free carnitine excretion in Fanconi syndrome patients correlated with total amino acid excretion (r = 0.76). Two cystinotic patients fasted for 24 h and one idiopathic Fanconi syndrome patient fasted for 5 h showed normal increases in plasma beta-hydroxybutyrate and acetoacetate, which suggested that hepatic fatty acid oxidation was intact despite very low plasma free carnitine levels. Muscle biopsies from two cystinotic subjects with Fanconi syndrome and plasma carnitine deficiency had 8.5 and 13.1 nmol free carnitine per milligram of noncollagen protein, respectively (normal controls, 22.3 and 17.1); total carnitines were 11.8 and 13.3 nmol/mg noncollagen protein (controls 33.5, 20.0). One biopsy revealed a mild increase in lipid droplets. The other showed mild myopathic features with variation in muscle fiber size, small vacuoles, and an increase in lipid droplets. In renal Fanconi syndrome, failure to reabsorb free and acyl carnitine results in a secondary plasma and muscle free carnitine deficiency.
Angiography in the Diagnosis of Gastrointestinal Diseases
Authors: ARTHUR D. SHIFF
Journal: Annals of Internal Medicine (1972)

We reviewed the charts of 226 patients who underwent diagnostic abdominal arteriography to determine when the procedure was most helpful in the delineation of gastrointestinal disorders. Gastrointestinal bleeding was the prime indication for abdominal angiography, to distinguish among several potential sites of massive bleeding or to locate a previously unknown site of chronic bleeding. In its venous phase, angiography gave information about the patency of the portal vein or portacaval shunt. In abdominal trauma angiography gave useful information about splenic or hepatic rupture. Abdominal angiography was of much less clinical value in the evaluation of patients with nonspecific abdominal pain or with suspected pancreatic cancer. Although hepatic angiography often clarified the nature of filling defects seen on hepatic scan, it missed many small lesions. It was of little value in patients with abdominal masses other than aneurysm.
The Breast: Comprehensive Management of Benign and Malignant Diseases
Authors: W. G. Abel
Journal: JAMA (1991)

Breast cancer constitutes 32% of all cancers in women, and it would not be unexpected if books devoted to this subject were commonplace. The first book in the United States devoted exclusively to the breast appeared in 1887, and subsequently some 240 more have been published. Recently, several excellent texts have appeared, and one may well ask "Why another?" First, there is always room for excellence, but, more important, the fast-moving field of breast cancer mandates continued updating, which this volume does very well. In the past two decades, there has been an explosion of information on breast disease with no apparent signs of plateauing. This current effort is large (more than 1000 pages) with 20 sections and 55 chapters covering the subject matter one would expect in a book purporting to be "comprehensive." The first chapter, on historical perspectives, is a welcome addition in an easily readable and informative
Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections
Authors: G. W. Elmer
Journal: JAMA (1996)

To evaluate the potential of biotherapeutic agents (microorganisms with therapeutic properties) for the prevention and/or treatment of selected intestinal and vaginal infections.The MEDLINE database was searched for all relevant articles published between 1966 and September 1995. Search terms used were biotherapeutic agent, probiotic, Lactobacillus, Saccharomyces, Bifidobacterium, Candida, gastrointestinal- system, vaginitis, vaginosis-bacterial, and related terms. The bibliographies of obtained articles were also reviewed.All placebo-controlled human studies on biotherapeutic agents were reviewed. English-language open trials, case series and reports, and animal studies were reviewed only if they were especially relevant to providing information on the potential efficacy, adverse effects, or mechanisms of action of these agents.Placebo-controlled studies have shown that biotherapeutic agents have been used successfully to prevent antibiotic-associated diarrhea (Lactobacillus caseiGG, bifidobacterium longum, B longum with L acidophilus, and Saccharomyces boulardii), to prevent acute infantile diarrhea (Bifidobacterium bifidum with Streptococcus thermophilus), to treat recurrent Clostridium difficile disease (S boulardii), and to treat various other diarrheal illnesses (Enterococcus faecium SF68, L caseiGG, and S boulardii). There is also evidence for Lactobacillus acidophilus in the prevention of candidal vaginitis. Few adverse effects have been reported. However, many of the studies tested only small numbers of patients or volunteers.There is now evidence that administration of selected microorganisms is beneficial in the prevention and treatment of certain intestinal and, possibly, treatment of vaginal infections. In an effort to decrease the reliance on antimicrobials, the time has come to carefully explore the therapeutic applications of biotherapeutic agents.
TREATMENT OF INTRACTABLE PAIN OF VISCERAL ORIGIN
Authors: I. Ridgeway Trimble
Journal: JAMA (1952)

The treatment of pain in 12 patients with widely disseminated cancer by means of interruption of the associated autonomic nerve pathways is the subject of this paper. Unfortunately, the problem of the control of this relentless, increasing, often agonizing pain is all too frequent. Nothing is more demoralizing than continuous pain. The sufferer generally loses interest in personal appearance, in cleanliness, and in ordinary relations with his family and friends. He becomes a piteous object, restless, sleepless, ever seeking relief that does not come.  Drugs in the form of analgesics, particularly the morphine derivatives, have their place; however, in many cases, after pain has been relieved for a time with these drugs, it recurs with greater severity than ever. Morphine lessens physical pain, but there are certain painful cancerous conditions in which morphine affords very inadequate relief, and relief that lasts only a short time. In many cases the pains
Interferon gamma receptor 1 88 G/A polymorphism and restenosis following coronary artery stenting
Authors: Klaus A. Tiroch, Olga Gorchakova, Werner Koch, Petra Hoppmann, Angela Ehrenhaft, Wolfgang Latz, Nicolas von Beckerath, Albert Schomig, Adnan Kastrati
Journal: Journal of the American College of Cardiology (2003)