tbuckley/cabot-search huggingface dataset:
Bronchial Carcinoma Treated with Nitrogen Mustard and Cyclophosphamide
Authors: K. M. Barran, W. H. Helm, D. A. King
Journal: BMJ (1965)

Nitrogen mustard (mustine hydrochloride) has been used in the treatment of lung cancer for 20 years. Lynch, Ware, and Gaensler (1950), Kent and Reh (1950), Levine and Weisberger (1955), Hatch, Bradford, and Ochsner (1956), and Bass (1960) have described their experience with this cytotoxic agent and have reported symptomatic improvement in many patients, but little or no prolongation of life. Since 1958, when cyclo phosphamide was synthesized, it has been widely used for malig nant disease, including lung cancer, both palliatively in advanced inoperable disease (Spear and Patno, 1962 ; Braun-Wotke, 1963), and as cover for operation in patients with less-advanced disease (Poulsen, 1962, 1963). Present Investigation Our primary aim was to assess the objective evidence of improvement in patients with bronchial carcinoma treated with nitrogen mustard and cyclophosphamide and to compare the results of the two agents. The secondary aim was to assess the effect of early  follow-up  treatment on the survival time in the patients who had improved. Selection of Patients.?The series ran for two years. At first all patients presenting with bronchial carcinoma at two chest clinics were included. After a short time patients who were suitable for operation were excluded because it was feared that cytotoxic therapy might be lowering the pulmonary diffusing capacity. Later investigations did not confirm this suspicion. There were 88 men and 9 women, and alternate male patients were given nitrogen mustard and cyclophosphamide, except at one peripheral hospital where it was difficult to manage intra venous nitrogen-mustard drips and all five male patients had cyclophosphamide. All female patients had nitrogen mustard. Diagnosis.?In 36 out of the 48 patients treated with nitrogen mustard and m 37 out of the 49 having cyclophosphamide,
Proton-Pump Inhibitors and Birth Defects — Some Reassurance, but More Needed
Authors: Allen A. Mitchell
Journal: New England Journal of Medicine (2010)

Limited data on safety are usually available when new medications are first marketed, but for appropriate ethical reasons, safety studies of the use of medications during pregnancy are rarely conducted before marketing. Because we must await postmarketing studies to resolve questions of fetal safety,1 it becomes critical to identify medications that are commonly used during pregnancy and to study them quickly. The report on proton-pump inhibitors (PPIs) in this issue of the Journal 2 is therefore both timely and important.Taking advantage of a series of linked databases covering every live-born infant in Denmark, Pasternak and Hviid identified increasingly high rates . . .
Truth Telling in Medicine-Reply
Authors: Mark Sheldon
Journal: JAMA (1982)

In Reply.—  I share many of the views expressed by Dr Boverman regarding the harmful effects that result from withholding the truth, and I agree that, in most cases, the truth ought to be disclosed. This was, for the most part, the point of my article. There are, however, two comments that I want to make regarding Dr Boverman's letter.  The first is that I am not sure that I share Dr Boverman's faith in the ability of current scientific research to give clear answers in regard to what ought to be done in particular situations. Sometimes it appears that the use of this current research represents an attempt to avoid the anxiety of dealing with real moral dilemmas by turning to a sort of technology in which the responsibility of the acting individual is dissipated among other professionals who are also acting on the basis of current research. I
Prevention is better than cure for emerging infectious diseases
Authors: D. L. Heymann, O. A. Dar
Journal: BMJ (2014)

Emerging infectious diseases have the potential to cause considerable morbidity, mortality, and economic damage. <b>David Heymann</b> and <b>Osman Dar</b> explain why we need to shift the emphasis from responding to emerging infections once they are detected to preventing them from occurring in the first place and describe one initiative that is working to achieve this
Assessment of non-mydriatic fundus photography in detection of diabetic retinopathy.
Authors: R Williams, S Nussey, R Humphry, G Thompson
Journal: BMJ (1986)

Non-mydriatic retinal photography with later interpretation of the photographs was assessed as a screening method for the detection of diabetic retinopathy; when compared with an ophthalmologist9s clinical assessment in a random group of 62 diabetic patients it was accurate (false negative 6.8%, false positive 2%) and sensitive (sensitivity 96%, specificity 98%). The assessment of further management required based on analysis of the photographs was 96.5% in agreement with the further management suggested by the ophthalmologist after direct clinical assessment of the patient. If this technique were used to screen patients in a typical diabetic clinic the predicted positive accuracy rate would be 84% and the predicted negative accuracy rate 99.5%.
Neonatal outcomes in babies born out of hours
Authors: D. Field, L. Smith
Journal: BMJ (2010)

Women should know the risks and benefits of giving birth in different settings

In the linked study (doi:10.1136/bmj.c3498), Pasupathy and colleagues assess the influence of time of birth on neonatal mortality in singleton term babies and identify an important increase in the risk of neonatal death associated with intrapartum anoxia when delivery occurs outside “normal working hours” of 9 am to 5 pm Monday to Friday.1

The question of whether the quality of provision of obstetric, maternity, and neonatal care varies out of hours has been long standing, and evidence is inconclusive. What is different about the current study is that the data are particularly robust and sufficiently comprehensive to allow the authors to remove or adjust for a range of important confounding factors. Their results show that in Scotland between 1985 and 2004, babies had an increased risk of dying as a result of intrapartum anoxia when delivery occurred outside the normal working week (adjusted odds ratio 1.71, 95% confidence interval 1.26 to 2.32). Although similar data are not available for the rest of the United …
Cerebral Artery Vasoconstriction and the Raynaud Phenomenon
Authors: ROBERT G. TRAPP
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 April 1987Cerebral Artery Vasoconstriction and the Raynaud PhenomenonROBERT G. TRAPP, M.D.ROBERT G. TRAPP, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-4-630_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Alexander and associates (1) show that patients with scleroderma and Raynaud phenomenon may also have cold-induced transient vasoconstriction of coronary arteries associated with abnormalities of myocardial function. Bulkley and coworkers (2) report the cases of nine patients with progressive systemic sclerosis and Raynaud phenomena who had sudden cardiac death and had normal coronary arteries at autopsy. Histologic study showed normal coronary arteries with focal thickening in only 10% of the small vessels. Other studies summarized by Alexander and associates (1) support further the concept that the well-known cutaneous manifestations of Raynaud phenomenon or disease may have a...References1. ALEXANDER E, FIRESTEIN G, and WEISS J. Reversible cold-induced abnormalities in myocardial perfusion and function in systemic sclerosis. Ann Intern Med. 1986;105:661-8. LinkGoogle Scholar2. BULKLEY B, KLASMANN P, and HUTCHINS G. Angina pectoris, myocardial infarction and sudden cardiac death with normal coronary arteries: clinics pathologic study of nine patients with progressive systemic sclerosis. Am Heart J. 1978;95:563-9. CrossrefMedlineGoogle Scholar3. BRODAL A. The autonomic nervous system. In: BRODAL A, ed. Neurological Anatomy in Relation to Clinical Medicine. 3rd ed. New York: Oxford University Press; 1981:771-3. Google Scholar4. NELSON E and RENNELS M. Innervation of intracranial arteries. Brain. 1970;93:475-90. CrossrefMedlineGoogle Scholar5. LEVY A, KURITZKY A, and SALAMON F. Raynaud's phenomenon complicated by recurrent brain infarction. Headache. 1984;24:256-8. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT G. TRAPP, M.D.Affiliations: Southern Illinois University School of Medicine Springfield, IL 62708 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1987Volume 106, Issue 4Page: 630-630KeywordsAutopsyCerebral arteriesCoronary arteriesSclerodermaSudden cardiac deathVasoconstriction ePublished: 1 December 2008 Issue Published: 1 April 1987 PDF downloadLoading ...
Nasal Potential Difference in Congenital Bilateral Absence of the Vas Deferens
Authors: UGO PRADAL, CARLO CASTELLANI, ANTONELLA DELMARCO, GIANNI MASTELLA
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Congenital bilateral absence of the vas deferens (CBAVD) is supposed to be due to defective activity of the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) in the genital tract. With the aim of studying CFTR activity in vivo we measured nasal potential difference (NPD) in a group of CBAVD subjects, who were then compared with normal control subjects and CF patients. Sodium transport, measured under basal conditions and after amiloride superinfusion, was normal in almost all CBAVD patients, who had NPD values similar to those of normal control subjects. Chloride transport was studied by measuring NPD during perfusion with a chloride-free solution and isoproterenol. Under these circumstances CBAVD patients as a whole showed normal chloride secretion. However, three subjects with CBAVD had abnormal NPD values. They had either elevated sweat chloride concentrations together with symptoms of mild CF, or compound heterozygosity ( Δ F508/R117H). In conclusion the group of CBAVD patients as a whole presented normal bioelectric properties of nasal epithelium, suggesting normal CFTR activity. In a small subgroup NPD was abnormal, suggesting a diagnosis of CF, later confirmed by elevated sweat chloride concentrations or positive DNA testing. We suggest that CBAVD patients with altered NPD should undergo further clinical follow-up in order to detect possible late complications of CF.
Elaine Marion Osborne (nee Sunderland)
Authors: C. Mavor
Journal: BMJ (2009)

After house jobs in Leeds and Bradford, Elaine Marion Osborne (nee Sunderland) worked in obstetrics and gynaecology in Leeds and Shotley Bridge. She joined up in 1952, becoming an officer in the Royal Army Medical Corps (RAMC) and was the medical officer …
Medical students' electives
Authors: T Sherwood
Journal: BMJ (1989)

depend on valproate for optimal control of their seizures throughout the childbearing years.5It is clearly of enormous importance that women with primary generalised epilepsies are differentiated from those with partial epilepsy, who will be best managed with carbamazepine.They are a group requiring specific counselling of the small risks of valproate to any pregnancy and needing screening of any pregnancy for neural tube defects within the first trimester.Patients themselves can probably best decide whether they wish to take the most effective drug and accept a small risk of neural tube defect or to take a less optimal drug that might be somewhat safer in pregnancy.
Birch pollen sensitization with cross-reactivity to food allergens predominates in adults with eosinophilic esophagitis
Authors: B. D. van Rhijn, R. van Ree, S. A. Versteeg, B. J. Vlieg-Boerstra, A. B. Sprikkelman, I. Terreehorst, A. J. P. M. Smout, A. J. Bredenoord
Journal: Allergy (2013)

EoE patients show variable sensitization patterns to food and aeroallergens. The value of allergy testing in adult EoE patients is unclear. Component-resolved diagnosis (CRD) may offer additional insights into sensitization patterns. The aim of this study was to characterize sensitization patterns in adult EoE patients using CRD. Serum from 76 patients (17 female), age 38.6 ± 1.5 years, was analyzed for reactivity to 112 different allergen components using an immuno-solid-phase allergen chip (ISAC). We observed any sensitization in 59 patients (78%), of which 54 patients were polysensitized. Aeroallergen sensitization, mostly against components of grass or tree pollen, or house dust mite, was observed in 74% of the patients. Birch pollen (rBet v 1) sensitization with cross-reactivity to food allergen components was observed in 30 patients (39%). In conclusion, food sensitizations in EoE patients are mainly caused by cross-reactivity to food allergens after primary birch pollen sensitization. Pollen and food sensitizations may cause or maintain esophageal inflammation in EoE patients. CRD provides more insight into sensitization patterns, identifies additional food allergen sensitizations and might be useful to direct dietary therapy in EoE.
Serum Immuno-conglutinin in Multiple Sclerosis, Hashimoto's Disease, and Rheumatoid Arthritis
Authors: E. A. Caspary, E. J. Ball
Journal: BMJ (1962)

B oi MMCLJUA will show whether liquid nitrogen is not only more convenient but also more efficient than glycerol.One red cell aldolase, one transaminaise and two TPN dependent dehydrogenases have been measured in these blood samples before and after storage for various periods.The level of the aldolase, and to a lesser extent that of the transaminase, fell significantly during storage but the concentration of the dehydrogenases was main- tained.These findings may have a bearing on the use for transfusion of blood stored by the present method.The method reported is rather more expensive than the glycerol method but more convenient in use.In particular, the rate of loss of cells during storage is much reduced, and recovery of cells for use is much quicker.It is suggested that liquid nitrogen represents a suitable alternative to glycerol for the smaller laboratory, allowing them to have their own red cell panel readily available.Thanks are due to Dr. A. Bracken, of the British Oxygen Company and to the Governors of St. Bartholomew's Hospital for arranging the regular supply of liquid nitrogen and to the Medical Research Council for providing the liquid-nitrogen storage cabinet.
PELVIC PERITONITIS. ITS TREATMENT BY ABDOMINAL SECTION.
Authors: W. H. LINK
Journal: JAMA (1892)

"The evil that men do lives after them, the good is oft interred with their bones." Especially is this true of those men who, in times past, have originated the so-called systems in gynecology. Pernicious doctrines, false theories, and discarded methods live and flourish luxuriantly among the rank and file of the profession long after thegreat teachers who put them forth have mouldered into dust. We hear men talk of ulceration as glibly as when gynecologists were nothing more than animated sticks of argenti nitras. There are yet those who labor diligently for weeks and torture patients for months trying to lift up with some sort of a pessary an enlarged and displaced uterus, fixed by inflammatory adhesions due to tubo-ovarian disease. The rage for sewing up the lacerated cervix without looking higher for pathological conditions is still gratifying the mechanical dexterity of gynecological enthusiasts who have never taught their
Psychiatric Illness and Contraction Abnormalities of the Esophagus
Authors: Ray E. Clouse, Patrick J. Lustman
Journal: New England Journal of Medicine (1983)

Over a six-month period 50 patients referred for clinical esophageal manometry were independently evaluated for psychiatric diagnoses to determine whether there was any association between psychiatric illness and esophageal motility disorders. The manometric studies were blindly classified according to findings in the esophageal body. Twenty-five patients were classified as having one or more of the following contraction abnormalities: an increase in mean wave amplitude, an increase in mean wave duration, an increased frequency of abnormal motor responses, or the presence of triple-peaked waves. Psychiatric diagnoses were made in 21 (84 per cent) of the 25 patients but in only 4 (31 per cent) of the 13 patients with normal manometric patterns (P less than 0.005) and 4 (33 per cent) of the 12 with other manometric abnormalities (P less than 0.01). The fact that psychiatric illness is associated with a specific cluster of esophageal contraction abnormalities may provide a basis for further investigation of the relation between emotional disturbances and disorders of gastrointestinal motility.
Metabolic Syndrome and Metabolic Abnormalities in Bipolar Disorder: A Meta-Analysis of Prevalence Rates and Moderators
Authors: Davy Vancampfort, Kristof Vansteelandt, Christoph U. Correll, Alex J. Mitchell, Amber De Herdt, Pascal Sienaert, Michel Probst, Marc De Hert
Journal: American Journal of Psychiatry (2013)

Patients with bipolar disorder have high levels of cardiovascular disease risk factors. The presence of metabolic syndrome significantly influences future cardiovascular disease morbidity and mortality. The authors sought to clarify the prevalence and moderators of metabolic syndrome in bipolar patients, accounting for subgroup differences.The authors searched MEDLINE, PsycINFO, EMBASE, and CINAHL through April 2012 for research reporting metabolic syndrome prevalence rates in bipolar patients. Medical subject headings "metabolic syndrome" and "bipolar" were used in the title, abstract, or index term fields. Manual searches were conducted using the reference lists from identified articles.The search yielded 81 articles in 37 publications (N=6,983). The overall metabolic syndrome rate was 37.3% (95% confidence interval [CI]=36.1-39.0) using any standardized metabolic syndrome criteria. Compared with general population groups, bipolar patients had higher metabolic syndrome rates (odds ratio=1.98; 95% CI=1.74-2.25). In bipolar patients, older age had a modest effect on the metabolic syndrome rate. The strongest moderator was the region in which the study took place, with the highest rates observed in New Zealand and Australia (64.2% [95% CI=38.3-83.9]) and North America (49.3% [95% CI=29.7-69.3]). Metabolic syndrome was significantly more prevalent in patients currently treated with antipsychotics (45.3% [95% CI=39.6-50.9] than in patients who were antipsychotic free (32.4% [95% CI=27.5-37.4]; odds ratio=1.72 [95% CI=1.24-2.38]).These findings strongly support the claim that patients with bipolar disorder are at high risk for metabolic syndrome and related cardiovascular morbidity and mortality and require regular monitoring and adequate preventive efforts and treatment for cardio-metabolic risk factors. These findings further suggest that the risk of metabolic syndrome is greater in bipolar patients taking prescribed antipsychotic medication.
Endoscopic Balloon Dilation for Removal of Bile Duct Stones: Special Indications Only
Authors: K. Huibregtse
Journal: Endoscopy (2001)

In this issue of Endoscopy, Arnold and colleagues report on a randomized pilot study comparing endoscopic balloon dilation (EBD) and endoscopic sphincterotomy (EST) for removal of bile duct stones [1]. The authors claim that their results indicate that EST is superior in terms of stone removal, complication rate and duration of the procedure and conclude that EST should remain the standard technique for endoscopic stone removal.
Desmoplastic trichoepithelioma: clinicopathological features and immunohistochemical study of the basement membrane proteins, laminin and type IV collagen
Authors: M. KALLIOINEN, M-L. TUOMI, K. DAMMERT, H. AUTIO-HARMAINEN
Journal: British Journal of Dermatology (1984)

Six desmoplastic trichoepitheliomas (DT) from four patients were studied immunohistochemically, using antibodies to the human PI fragment of laminin and the 7S domain of type IV collagen. The staining of the basement membrane around the tumour clusters was distinct and continuous in most areas, but there were discontinuities and a granular appearance of the basement membrane in the areas of keratinized cysts and calcification around some unorganized epithelial cell nests. The discontinuities of the basement membranes may be a sign of epithelial degeneration or altered differentiation rather than malignancy.
892 RESTORATION OF FUNCTIONAL PROPERTIES OF DENDRITIC CELLS USING PEPTIDE INHIBITORS OF INTERLEUKIN 10: APPLICATION TO HEPATITIS C VIRUS INFECTION
Authors: N. Díaz-Valdés, L. Manterola, V. Belsúe, J.I. Riezu-Boj, E. Larrea, J. López-Sagaseta, J. Hermida, J. Prieto, J.J. Lasarte, F. Borrás-Cuesta, P. Sarobe
Journal: Journal of Hepatology (2009)
Medicines to remain with European Commission health directorate
Authors: R. Watson
Journal: BMJ (2014)

The incoming European Commission president, Jean-Claude Juncker, has had to backtrack over his earlier decision to transfer responsibility for medicines and the European Medicines Agency away from the commission’s health directorate to its industry and enterprise directorate.

The initial announcement in September led to widespread concern in the public health sector. It feared that industry and commercial interests would weigh more heavily than patient safety and medical considerations when future legislation or drug authorisation was being considered.1

The proposed transfer prompted high profile protests as members of the European Parliament, led by the British Labour member Glenis Willmott, non-governmental organisations, and …
The origin of the major cystic fibrosis mutation (ΔF508) in European populations
Authors: N. Morral, J. Bertranpetit, X. Estivill, V. Nunes, T. Casals, J. Giménez, A. Reis, R. Varon-Mateeva, M. Macek, L. Kalaydjieva, D. Angelicheva, R. Dancheva, G. Romeo, M.P. Russo, S. Garnerone, G. Restagno, M. Ferrari, C. Magnani, M. Claustres, M. Desgeorges, M. Schwartz, M. Schwarz, B. Dallapiccola, G. Novelli, C. Ferec, M. de Arce, M. Nemeti, J. Kere, M. Anvret, N. Dahl, L. Kadasi
Journal: Nature Genetics (1994)
Letter by Espinoza Regarding Article, “Pilot Study of Extracorporeal Removal of Soluble Fms-Like Tyrosine Kinase 1 in Preeclampsia”
Authors: Jimmy Espinoza
Journal: Circulation (2012)

We read with interest the case reports of Thadhani et al. 1 They may represent the first reports on extracorporeal removal of an antiangiogenic factor for the management of early-onset preeclampsia, and the authors should be congratulated on their efforts.The authors claimed that patients with fetal growth restriction (defined at Ͻ5th percentile for gestational age) were excluded; however, the conventional definition of intrauterine growth restriction proposed by the American College of Obstetricians and Gynecologists is an estimated fetal weight below the 10th percentile. 2 According to this definition, all 3 cases fulfilled the criteria for intrauterine growth restriction.Moreover, fetal growth during the study period appeared to be suboptimal. 3To this extent, it is possible that suboptimal growth may be the result of pathophysiological changes associated with severe preeclampsia, but a contribution of the extracorporeal removal of antiangiogenic factors cannot be excluded, in a similar fashion as an overzealous management of maternal hypertension is associated with fetal growth restriction. 4This has particular relevance in view of the fact that preeclampsia may represent the maternal manifestation of a fetal adaptation in response to absolute or relative uteroplacental ischemia.It is possible that fetal signaling in this context may raise maternal blood pressure in an attempt to increase uteroplacental blood flow and improve fetal growth.Thus, attempts to limit this adaptive response may be associated with suboptimal fetal growth.Future studies including the novel interven-tion proposed by Thadhani et al 1 might need to provide the appropriate balance between maternal blood pressure regulation, adequate fetal growth, and pregnancy prolongation in patients with early-onset preeclampsia.