tbuckley/cabot-search huggingface dataset:
O3 ADDING PEGINTERFERON TO ENTECAVIR INCREASES RESPONSE RATES IN HBeAg-POSITIVE CHRONIC HEPATITIS B PATIENTS: WEEK 96 RESULTS OF A GLOBAL MULTICENTER RANDOMISED TRIAL (ARES STUDY)
Authors: W.P. Brouwer, Q. Xie, M.J. Sonneveld, N.P. Zhang, Q. Zhang, F. Tabak, A. Streinu, J.-Y. Wang, R. Idilman, H.W. Reesink, M. Diculescu, K. Simon, M. Voiculescu, M. Akdogan, W. Mazur, J.G.P. Reijnders, E. Verhey, B.E. Hansen, H.L.A. Janssen
Journal: Journal of Hepatology (2014)
WMA sets rules on how doctors handle industry sponsorship
Authors: Zosia Kmietowicz
Journal: BMJ (2004)

The World Medical Association has published its first guidelines on how doctors should handle their relationship with commercial enterprises.

The guidelines, which cover medical conferences, gifts, research, and affiliations, are a bid to satisfy the public's demands for greater transparency in doctors' relationship with the pharmaceutical industry.

In a statement issued at its annual general assembly this week in Tokyo the World Medical Association acknowledged that industry support helps doctors carry out medical research, attend scientific conferences, and learn about new medical developments. But conflicts of interest occur when commercial …
Drug Therapy for Portal Hypertension
Authors: WILLIAM G. RECTOR
Journal: Annals of Internal Medicine (1986)

Drugs used to treat portal hypertension cause constriction of mesenteric arterioles, reducing inflow to the portal venous system, portal pressure, and flow through portasystemic collaterals (such as esophageal varices). Vasopressin and somatostatin are direct vasoconstrictors. Propranolol acts by blocking vasodilatory betai receptors and reducing cardiac output. A major side effect of vasopressin therapy is impaired cardiac performance secondary to coronary vasoconstriction and increased work against high arterial pressure. Infusion of vasopressin together with a cardiac inotrope or a vasodilator, and administration of vasopressin as an inactive "hormonogen" from which it is slowly released in vivo, may lessen adverse effects. Somatostatin appears to act selectively in the mesenteric circulation. Controlled trials indicate that vasopressin may be useful for controlling hemorrhage from esophageal varices and that somatostatin works at least as well as vasopressin. Propranolol treatment has been used to prevent variceal bleeding; however, controlled trials of its effectiveness have produced conflicting results.
Monovalent cation leaks in human red cells caused by single amino-acid substitutions in the transport domain of the band 3 chloride-bicarbonate exchanger, AE1
Authors: Lesley J Bruce, Hannah C Robinson, Hélène Guizouarn, Franck Borgese, Penny Harrison, May-Jean King, Jeroen S Goede, Suzanne E Coles, Daniel M Gore, Hans U Lutz, Romina Ficarella, D Mark Layton, Achille Iolascon, J Clive Ellory, Gordon W Stewart
Journal: Nature Genetics (2005)
Association of Exposure to Phthalates with Endometriosis and Uterine Leiomyomata: Findings from NHANES, 1999–2004
Authors: Jennifer Weuve, Russ Hauser, Antonia M. Calafat, Stacey A. Missmer, Lauren A. Wise
Journal: Environmental Health Perspectives (2010)

BackgroundPhthalates are ubiquitous chemicals used in consumer products. Some phthalates are reproductive toxicants in experimental animals, but human data are limited.ObjectiveWe conducted a cross-sectional study of urinary phthalate metabolite concentrations in relation to self-reported history of endometriosis and uterine leiomyomata among 1,227 women 20–54 years of age from three cycles of the National Health and Nutrition Examination Survey (NHANES), 1999–2004.MethodsWe examined four phthalate metabolites: mono(2-ethylhexyl) phthalate (MEHP), monobutyl phthalate (MBP), monoethyl phthalate (MEP), and monobenzyl phthalate (MBzP). From the last two NHANES cycles, we also examined mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP). We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders.ResultsEighty-seven (7%) and 151 (12%) women reported diagnoses of endometriosis and leiomyomata, respectively. The ORs comparing the highest versus lowest three quartiles of urinary MBP were 1.36 (95% CI, 0.77–2.41) for endometriosis, 1.56 (95% CI, 0.93–2.61) for leiomyomata, and 1.71 (95% CI, 1.07–2.75) for both conditions combined. The corresponding ORs for MEHP were 0.44 (95% CI, 0.19–1.02) for endometriosis, 0.63 (95% CI, 0.35–1.12) for leiomyomata, and 0.59 (95% CI, 0.37–0.95) for both conditions combined. Findings for MEHHP and MEOHP agreed with findings for MEHP with respect to endometriosis only. We observed null associations for MEP and MBzP. Associations were similar when we excluded women diagnosed &gt; 7 years before their NHANES evaluation.ConclusionThe positive associations for MBP and inverse associations for MEHP in relation to endometriosis and leiomyomata warrant investigation in prospective studies.
Efficacy of Tremacamra, a Soluble Intercellular Adhesion Molecule 1, for Experimental Rhinovirus Infection
Authors: Ronald B. Turner, Margaret T. Wecker, Gerhardt Pohl, Theodore J. Witek, Eugene McNally, Roger St. George, Birgit Winther, Frederick G. Hayden
Journal: JAMA (1999)

ContextAttachment of most rhinovirus subtypes to cells depends on a cellular receptor, the intercellular adhesion molecule 1 (ICAM-1). A recombinant soluble ICAM-1 (tremacamra, formerly BIRR 4) has shown possible efficacy in early studies.ObjectiveTo determine the efficacy and safety of intranasal administration of tremacamra in experimental rhinovirus colds in humans.DesignFour randomized, double-blind, placebo-controlled trials conducted in January to March 1996.Setting and SubjectsVolunteers between the ages of 18 and 60 years who had an antibody titer of 1:4 or less to the challenge virus. Subjects were isolated in a hotel room during study days 0 to 8; symptoms were recorded through day 14. A total of 198 subjects were randomized, of whom 196 received drug or placebo and were included in the safety analysis. A total of 177 subjects were included in the efficacy analysis.InterventionsTremacamra or placebo was given beginning 7 hours before inoculation with rhinovirus type 39 (preinoculation studies) or 12 hours after (postinoculation studies). Tremacamra as an inhaled solution or as a powder (each given preinoculation and postinoculation for a total of 4 studies) and placebo were given in 6 doses at 3-hour intervals daily during days 1 through 7. Recipients of active treatment received 367 µg of tremacamra per nostril per dose for a total of 4.4 mg/d.Main Outcome MeasuresEffect of tremacamra on infection, as determined by virus isolation and seroconversion, and on illness, as determined by symptom scores, clinical colds, and nasal mucus weights. Treatment-by-study interaction was not significant, so results were pooled for the main analysis.ResultsA total of 88 (92%) of the 96 subjects in the placebo groups and 69 (85%) of the 81 subjects in the active treatment groups were infected (P=.19). For placebo vs tremacamra, respectively, the total symptom score (± 95% confidence interval [CI]) was 17.6 (± 2.7) vs 9.6 (± 2.9), the proportion of clinical colds was 64/96 (67% ± 9%) vs 36/81 (44% ± 11%), and the nasal mucus weight was 32.9 (± 8.8) g vs 14.5 (± 9.4) g (P<.001 for all comparisons). Tremacamra was not associated with adverse effects or evidence of absorption through the nasal mucosa and did not interfere with development of neutralizing antibody.ConclusionTremacamra reduced the severity of experimental rhinovirus colds. Whether tremacamra will be useful clinically will require further study.
Physicians and Execution — Highlights from a Discussion of Lethal Injection
Authors: Atul Gawande, Deborah W. Denno, Robert D. Truog, David Waisel
Journal: New England Journal of Medicine (2008)

On January 14, 2008, the Journal hosted a videotaped roundtable discussion of the issues raised by Baze v. Rees, currently before the Supreme Court, that asks whether the three-drug protocol used to carry out the death penalty by lethal injection causes unnecessary pain and suffering in violation of the Constitutional ban on cruel and unusual punishment. Moderator Atul Gawande was joined by law professor Deborah Denno, anesthesiologist–ethicist Robert Truog, and anesthesiologist David Waisel. What follows are highlights of their discussion about lethal injection, the current protocol, possible alternatives, and the role of physicians and other health care professionals in putting convicted criminals to death. The video, along with a related reader poll and an interactive timeline, can be found at www.nejm.org.The ProtocolDr. David Waisel: The three-drug protocol is based on what was considered a normal induction of anesthesia when it was developed. [The first drug is] thiopental, also known as sodium thiopental or pentothal, which is a barbiturate, which is designed to put you to sleep, create amnesia and anesthesia. Second comes pancuronium bromide, which is designed to paralyze the muscles. And the third drug, which is not a drug used in anesthesia, is potassium chloride, which is designed to rapidly stop the heart. The doses used are massive compared to the doses that would be used in a . . .
Erythrocyte Metabolism in Hemolysis
Authors: Jane F. Desforges
Journal: New England Journal of Medicine (1965)

THE life-span of the erythrocyte in the circulation is a limited one conditioned by both extracellular environment and intracellular events. In normal subjects, red cells survive for approximately a hundred and twenty days, and the survival curve of a random sample demonstrates an arithmetic rate of disappearance over this period. However, in patients with hemolytic anemia, a more complex disappearance rate may be found with superimposition of a simple logarithmic or a variable disappearance rate on the normal aging slope. In interpreting the events that precede and are associated with hemolysis in disease, one must bear in mind the normal . . .
CHEMOTHERAPY OF TRYPANOSOME AND SPIROCHETE INFECTIONS
Authors: Walter A. Jacobs, Michael Heidelberger
Journal: The Journal of Experimental Medicine (1919)

Early twentieth-century scientists had long been attempting to treat trypanosomiasis, or African Sleeping Sickness, with arsenic-based
   compounds.  Unfortunately, these compounds were largely ineffective and highly toxic. In light of this, Heidelberger and Walter
   Jacobs began work to formulate an alternate treatment for the disease.  This article describes the pair's successful creation
   of a simple, non-toxic, and easily made arsenic compound to treat sleeping sickness, which Simon Flexner, director of the
   Rockefeller Institute, named tryparasamide.
Recent advances in gastroenterology 5
Authors: G Neale
Journal: Gut (1984)

Empyema of the gall bladder Sir, The excellent article written by Dr Thornton and colleagues about empyema of the gall bladder (Gut 1983; 24: 1183-5) raises the problem of distinguishing cholecystitis from gall bladder empyema.The whitish, purulent-like fluid often found in a gall bladder with cholecystitis, composed of calcium and bilirubin precipitates, debris, and a few white blood cells, often with bacteria, is not very different from pus collected from a gall bladder with empyema, which often contains remarkably few
Balloon Pulmonary Angioplasty for Treatment of Chronic Thromboembolic Pulmonary Hypertension
Authors: Jeffrey A. Feinstein, Samuel Z. Goldhaber, James E. Lock, Susan M. Ferndandes, Michael J. Landzberg
Journal: Circulation (2001)

Although pulmonary thromboendarterectomy is increasingly successful for the definitive treatment of chronic thromboembolic pulmonary hypertension (CTEPH), not all patients have surgically accessible disease. Others are poor surgical candidates because of comorbid illness. Therefore, for selected patients, we defined and implemented an alternative interventional strategy of balloon pulmonary angioplasty (BPA).Eighteen patients (mean age, 51.8 years; range, 14 to 75 years) with CTEPH underwent BPA; they averaged 2.6 procedures (range, 1 to 5) and 6 dilations (range, 1 to 12). Selection of pulmonary artery segments for dilation required (1) complete occlusion, (2) filling defects, or (3) signs of intravascular webs. After an average of 36 months of follow-up (range, 0.5 to 66 months), the average New York Heart Association class improved from 3.3 to 1.8 (P:<0.001), and 6-minute walking distances increased from 209 to 497 yards (P:<0.0001). Pulmonary artery mean pressures decreased from 43.0+/-12.1 to 33. 7+/-10.2 mm Hg (P:=0.007). Eleven patients developed reperfusion pulmonary edema; 3 required mechanical ventilation.BPA reduces pulmonary artery hypertension in patients with CTEPH and is associated with long-term improvement in New York Heart Association class and 6-minute walking distances. BPA is a promising interventional technique that warrants randomized comparison with medical therapy in CTEPH patients who are not surgical candidates.
Medical Charities Appeal
Authors: H. Dodd
Journal: BMJ (1968)

posts are advertised there could be included the provision " Consideration will be given to candidates who are interested in doing a year or longer in a developing country."For such a senior house post I applied successfully and found a position in Tanzania through Voluntary Service Overseas, who were able to offer a one-year's contract.My wife was found a teaching vacancy in the same town.In my first six months as a medical officer in a regional hospital my experience has included the following: Care of a children's ward, two male medical, a female medical, and isolation wards ; relief duties for obstet- rics and gynaecology; staff clinic; outpatient clinics seeing about 150 people a day; on- call duties for 220-bed hospital with advice and practical instruction from a long-
Advancing the Science of Patient Safety
Authors: Paul G. Shekelle, Peter J. Pronovost, Robert M. Wachter, Stephanie L. Taylor, Sydney M. Dy, Robbie Foy, Susanne Hempel, Kathryn M. McDonald, John Ovretveit, Lisa V. Rubenstein, Alyce S. Adams, Peter B. Angood, David W. Bates, Leonard Bickman, Pascale Carayon, Liam Donaldson, Naihua Duan, Donna O. Farley, Trisha Greenhalgh, John Haughom, Eileen T. Lake, Richard Lilford, Kathleen N. Lohr, Gregg S. Meyer, Marlene R. Miller, Duncan V. Neuhauser, Gery Ryan, Sanjay Saint, Kaveh G. Shojania, Stephen M. Shortell, David P. Stevens, Kieran Walshe
Journal: Annals of Internal Medicine (2011)

Despite a decade's worth of effort, patient safety has improved slowly, in part because of the limited evidence base for the development and widespread dissemination of successful patient safety practices. The Agency for Healthcare Research and Quality sponsored an international group of experts in patient safety and evaluation methods to develop criteria to improve the design, evaluation, and reporting of practice research in patient safety. This article reports the findings and recommendations of this group, which include greater use of theory and logic models, more detailed descriptions of interventions and their implementation, enhanced explanation of desired and unintended outcomes, and better description and measurement of context and of how context influences interventions. Using these criteria and measuring and reporting contexts will improve the science of patient safety.
Aerosolized Administration of <i>N</i>-Acetylcysteine Attenuates Lung Fibrosis Induced by Bleomycin in Mice
Authors: SHIN-ICHI HAGIWARA, YOSHIKI ISHII, SATOSHI KITAMURA
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Reactive oxygen species (ROS) play an important role in the pathogenesis of pulmonary fibrosis. We previously demonstrated that N-acetylcysteine (NAC), an antioxidant, inhibited adhesion molecule expression and cytokine production in lung cells. When NAC is inhaled into the alveolar space, it is expected to directly interact with inflammatory cells and to elevate glutathione levels in the epithelial lining fluids. We therefore examined whether inhaled NAC inhibits lung fibrosis induced by bleomycin (BLM). Male ICR mice were given a single intravenous injection of BLM (150 mg/ kg). Thirty milliliters of NAC (70 mg/ml) or saline were inhaled twice a day for 28 d using an ultrasonic nebulizer. In the inflammatory phase (Day 7), NAC administration attenuated the cellular infiltration in both bronchoalveolar lavage fluid (BALF) and alveolar tissues. At Day 28, the fibrotic changes estimated by Aschroft's criteria and hydroxyproline content in the NAC inhalation group were significantly decreased compared with the BLM-only group (p < 0.05). CXC chemokines, macrophage inflammatory protein-2 (MIP-2), cytokine-induced neutrophil chemoattractant (KC), and CC chemokines, macrophage inflammatory protein-1alpha (MIP-1alpha), in BALF were mostly elevated on Day 7 in the BLM-only group; however, these elevations were significantly repressed by NAC inhalation (p < 0.05). Lipid hydroperoxide (LPO) was also quantified in BALF. LPO was markedly increased on Day 3 in the BLM-only group, and this increase was significantly decreased by NAC inhalation (p < 0.05). These results revealed that aerosolized NAC ameliorated acute pulmonary inflammation induced by BLM injection via the repression of chemokines and LPO production, resulting in the attenuation of subsequent lung fibrosis. These findings are limited to the BLM-induced lung fibrosis animal model. However, NAC inhalation will be expected to be a potential therapy for patients with other interstitial pneumonias because ROS are involved in the pathogenesis of lung injury in most interstitial pneumonia.
Icarus's syndrome: new hazards in flight.
Authors: G M Yuill
Journal: BMJ (1977)

The British Hang Gliding Association accident report for 1975 reported two deaths. The remaining cases were predominantly limb fractures. The major causes of the injuries were inexperience, high wind speed, turbulence, and stalling. It is contended that the sport is no more risky than is rock climbing, motor-bike racing, skiing, or potholing, yet against these undoubtedly dangerous sports no threat of prohibition exists. The current accident rate in hang gliding could be reduced dramatically by the provision of proper courses of instruction.
A search for a threshold in the relationship of air pollution to mortality: a reanalysis of data on London winters.
Authors: B Ostro
Journal: Environmental Health Perspectives (1984)

The relationship between air pollution and increased risk of mortality has been explored previously using data on 14 winters in London. The results of these analyses have been used to determine a no-observable-effects level. This reanalysis of the data finds no evidence to support the existence of a no-effects level. Further, the reanalysis suggests that the estimated pollution-mortality relationship exists even in nonepisodic winters, when British Smoke readings were less than 500 micrograms/m3.
On a New and Successful Mode of Treating Fever
Authors: W. Gill
Journal: BMJ (1847)

NEW MODE, OF -TREATING FEVER, closed cells, and consequent upon two necessary ante- cedents,-a vtalpower or inherent disposition imparted from the parent to the offspring, and certain external conditionw, in which are included food, air, water, and temperature.The lowest living beings are simple isolated-cells; the next in order are aggregatqof uliglhtly-cohering-cells; then follow the structures*.composed of coherent-cells; after wbich come the ,i/brow and cartilaginous textures; and lastly, bone or wood.And it is to be particularly observed as we ascend the scale of animated nature, that the addifional later-formed or higher elements do not supersede, but, are superadded to, the priorones:-thusfibrouselemenins are superadded to the cellular; cartilaginous to the fibrous and cellular; and bone to the cartilaginous, the fibrous, and cellular, until in the human body we meet with all the varieties,-osseous, cartilaginou, fibrous, and coherent cellular textures, superadded to slightly coherent and incoherent cells.All thedetextures, and every organ in the human body, in their
Just in time information for clinicians: a questionnaire evaluation of the ATTRACT project
Authors: J. Brassey
Journal: BMJ (2001)

General practitioners generate many clinical questions during consultations. 1 2 However, when they seek answers to these queries they tend to rely on colleagues and "desk top" references rather than searching the literature themselves. [1]][3] ATTRACT was created in 1997 to provide rapid, evidence based summaries to clinical queries.All general practitioners in Gwent were invited to send their clinical queries to ATTRACT.For each query an information manager (JB) undertook a rapid search of the literature.The information found was appraised, summarised onto one side of A4 paper, and faxed to the requestor within six hours (see appendix on the BMJ's website for more details on the search, appraisal, and summary process).Examples of the questions received include "Do decongestants help in people with eustachian tube dysfunction?" and "What are the risks of flying while pregnant?"(see BMJ's website for list of most popular questions).We report here an initial evaluation of this service.
Redundancy of conventional articular response variables used in juvenile chronic arthritis clinical trials.
Authors: N Ruperto, E H Giannini
Journal: Annals of the Rheumatic Diseases (1996)

OBJECTIVE--To estimate the degree of redundancy among articular response variables used routinely in juvenile chronic arthritis (JCA) clinical trials. METHODS--We obtained data from a large, computerised databank holding information from multiple clinical trials in children with JCA to determine Pearson correlation coefficients for changes from baseline values in articular response variables. All 508 JCA patients who entered the analysis of efficacy of the original trials were included in the present study. An r value of 0.7 or greater was considered evidence of colinearity. RESULTS--When changes in joint counts of articular manifestations were compared with changes in the respective severity scores (for example swollen joint count versus swelling severity score), the r values were always &gt; or = 0.7. Three articular response variables related to the assessment of pain are all highly correlated with each other. The number of joints with active arthritis was correlated with the number of joints with swelling and the swelling score. Change in the overall severity score was highly correlated (r &gt; or = 0.7) with change in nearly all articular response variables. CONCLUSIONS--Many endpoints reported in JCA trials are redundant, especially counts and scores of the same articular measure. Eliminating redundant variables would provide the same information with less complexity, and decrease the probability of statistical error and ambiguous results.
The Meaning and Methods of Success: Introductory Address Given at St. George's Hospital, October 1st, 1927
Authors: H. Rolleston
Journal: BMJ (1927)

A-FTER congratulating the winners of scholarships, prizes, and certificates, and mentioning some of the advantages of competing for these rewards of ability and industry, Sir Humphry iRolleston discussed briefly the element of chance in the success or failure of a medical career.Looking back upon-the careers of contemporary students and colleagues, it seemed to him that what might appear to the onlooker to be pure luck was often a capacity to make full use of whatever the wheel of fate brought to the feet.He then considered some of the essentials for a right conception of sucoess in medical life, and the various forms which this success might take-the fashionable and financial, the intra-professional, the scientific and intellectual, the humanitarian and personal.The best form of success for the ordinary man to aim at was to preserve his own peace of mind and respect by the consciousness of honest work well done and duty carried out without fear or favour, by making others happier in body and mind, and by freedom from regrets for any action contrary to the golden rule " Do unto others as you would that they should do unto you."]