tbuckley/cabot-search huggingface dataset:
EVALUATION OF IMMEDIATE AND LATE RESULTS OF PREFRONTAL LOBOTOMY IN 600 CASES, INCLUDING A CASE OF POST-ENCEPHALITIS AND OTHER ORGANIC STATES
Authors: HARRY J. WORTHING, HENRY BRILL, HENRY WIGDERSON
Journal: American Journal of Psychiatry (1951)

A report is presented on a series of 600 cases of prefrontal lobotomy done by a modification of the Lyerly technique. This series has been operated by the same surgeon and followed throughout by the same psychiatrists. The authors feel that the operation is therapeutically active, and is useful and practicable. The psychiatric response has so far been found to be stable and progressive. No late deteriorative or other late unfavorable psychic effects have been noted. About 1% of the patients are considered psychiatrically worse after the operation. "Personality changes" have not been a practical problem and complaints that could be classed in this category have been infrequent, of minor significance, and have tended to disappear in the course of the first year or two postoperatively. Schizophrenic defect states of the usual pattern and distribution have been noted. Spontaneous postlobotomy convulsions have not been found to exert a favorable clinical effect, although lobotomy patients show the usual symptomatic response to convulsions induced by electric shock. Spontaneous convulsions tend to occur in groups and seem to be more frequent in catatonic patients than in others(1). Nonschizophrenic cases represented approximately 10% of the operated series of 600 and 12% of the releases of the entire series. Release rates for patients of 3 years or less of hospital residence were definitely better than those of longer hospital residence, and it was also found that the quality of remission was less satisfactory in older cases. A very important effect of the operation, behavior improvement, developed in even the most chronic cases although in smaller proportion than in less chronic ones. Approximately two-thirds of all operated cases remaining in the hospital showed material improvement in such behavior disorder as aggressiveness, destructiveness, wetting, soiling, homosexual behavior on a psychotic level, refusal of food, etc. After a period of postoperative observation that now ranges from 1 to 4 years, it appears that approximately one-third of all operated cases have been able to return to their homes and to remain there. This proportion is very much higher than what one could expect from a group of unoperated cases of similar clinical picture, similar duration of hospital residence, and similar diagnosis. Prefrontal lobotomy was carried out for clear-cut indications in one case of moderately advanced postencephalitic parkinsonism, one general paretic, one case of muscular dystrophy, one mild case of congenital cerebral palsy. The psychiatric response of these cases was not notably different from that seen in "functional cases" with regard to psychotic manifestations, and in no case was there any intensification of the primary organic condition. No beneficial effects were noted after lobotomy in 2 cases of primary psychopathic behavior.
Do Reference Standards Hold Back the Progress of Medicine?
Authors: Yvo M. Smulders
Journal: Annals of Internal Medicine (2009)

Letters19 May 2009Do Reference Standards Hold Back the Progress of Medicine?Yvo M. Smulders, MD and Abel Thijs, MDYvo M. Smulders, MDFrom VU University Medical Center, 1007MB Amsterdam, the Netherlands.Search for more papers by this author and Abel Thijs, MDFrom VU University Medical Center, 1007MB Amsterdam, the Netherlands.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-10-200905190-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the article by Glasziou and colleagues (1) addressing criteria for new diagnostic tests to become reference standards for specific diseases. We believe the emphasis in the evaluation of new tests should not be on how to incorporate them in the existing diagnostic framework, but on their potential to alter disease classification, in particular severity grading and taxonomy. The term “reference (gold) standard” distracts from these opportunities and should be avoided.A new test can alter diagnosis in 3 ways. First, a new test might diagnose exactly the same disease with better accuracy, in ...References1. Glasziou P, Irwig L, Deeks JJ. When should a new test become the current reference standard? Ann Intern Med. 2008;149:816-22. [PMID: 19047029] LinkGoogle Scholar2. Feinstein AR. “Clinical judgment” revisited: the distraction of quantitative models. Ann Intern Med. 1994;120:799-805. [PMID: 8147553] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Yvo M. Smulders, MD; Abel Thijs, MDAffiliations: From VU University Medical Center, 1007MB Amsterdam, the Netherlands.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Judgment Revisited: The Distraction of Quantitative Models Alvan R. Feinstein When Should a New Test Become the Current Reference Standard? Paul Glasziou , Les Irwig , and Jonathan J. Deeks Do Reference Standards Hold Back the Progress of Medicine? Paul Glasziou , Les Irwig , and Jonathan Deeks Metrics 19 May 2009Volume 150, Issue 10 Page: 735 Keywords Falls Helicobacter pylori Imaging techniques Infectious diseases Ischemia Myocardial infarction Pathogenesis Peptic ulcers Perception Specificity ePublished: 19 May 2009 Issue Published: 19 May 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Kinematics and kinetics of accidental ankle sprain in 3D motion analysis lab
Authors: E Kristianslund, R Bahr, T Krosshaug
Journal: British Journal of Sports Medicine (2011)

Background Ankle sprain is among the most frequent sports injuries and a significant contributor to time lost from sports participation. The injury mechanism is traditionally described as an inversion trauma, but a detailed description including joint kinetics is lacking. Objective To provide an accurate description of an ankle sprain. Design Case study. Setting Sidestep cutting in 240 Hz motion analysis lab. Patient Elite female team handball player (1.73 m, 63.7 kg, 22 years). Accidental grade 1 ankle sprain confirmed by orthopaedic surgeon. Assessment and outcome Ankle kinetics and kinematics and ground reaction forces were compared between two normal trials and the injury trial. Results In the injury trial we observed a sudden increase in ankle inversion (15° vs 4.9° and 4.8°) and ankle internal rotation (6.9° vs −1.2° and −3.6°) the first 50 ms. The injury trial centre of pressure had an increased lateral excursion after 50 ms (8.4 cm vs 3.3 and 3.0 cm). From 80 ms there was an increasing ankle inversion moment, reaching a peak of 72 Nm at 138 ms. At this time the ankle inversion angle had reached 33.1°, the ankle internal rotation angle was 53.7° and the ankle dorsiflexion was 26.5°. In the same period there appeared to be an attempted unloading of the foot, with a dorsiflexion of the ankle and reduced ground reaction force. The control trials displayed mainly eversion moment of the ankle throughout the stance phase, and joint angular deflections less than 6°. Conclusion This study provides the most accurate and detailed description of ankle sprain dynamics to date. The injury involved inversion and internal rotation combined with an unloading of the foot that was initiated after approx 80 ms. The inversion moment likely caused the injury in the time period between 120 and 150 ms.
Sustained Depressor Effect of Renal Medullary Extract in the Normotensive Rat
Authors: JAMES B. LEE, ROGER B. HICKLER, CALVIN A. SARAVIS, GEORGE W. THORN
Journal: Circulation Research (1963)

Crude homogenates of rabbit, medulla produced a sustained depression of blood pressure when injected intravenously into the normotensive, anesthetized, pentolinium-treated rat. Similar activity was present in rat medulla, but not in extracts of renin-free cortex or certain nonrenal tissues. The sustained depressor activity of medulary extract possessed different physiological and chemical characteristics from the shortacting nucleotide depressor activity which is present in both cortical and medullary extracts. In addition, prolonged medullary depressor activity was separable from medullary nucleotide activity by column chromatography. The activity responsible for sustained depressor activity was a dialyzable, ethanol soluble, low molecular weight(&lt;4500 mol wt) substance(s) which was resistant to a mixture of peptide hydrolases and destroyed by heating for one hour at 100°C.
MEP proposes giving patients the right to seek treatment abroad without prior government approval
Authors: Madeleine Brettingham
Journal: BMJ (2005)

Patients will have the right to seek treatment abroad if they believe they are being made to wait too long in their home country, under proposals being made by John Bowis, an MEP to the European parliament, next month.

Mr Bowis's proposals, written in the wake of discussions by the European Commission's group on patient mobility and health care, will give patients the right to book themselves treatment in hospitals in other member states through the NHS. Currently patients have to seek authorisation from their home government if they wish their national health service to foot the bill.

Mr Bowis, a former Conservative health minister, denied that this would lead to unsustainably high levels of health tourism and insisted that the moves would act as an incentive to countries to improve their health …
TRENCH FEVER AND ITS ALLIES
Authors: W. P. Herringham
Journal: BMJ (1917)

carriers among the troops.Tllus, in one regiment a carrier was discovered in the regimental kitchen.In dnothler, which had lately received reinforcements, no less tllan 96-men had to be examined before'tlhe carrier was found.Bit the source of infection was not always in the troops.The pa t of Flanders that we held was a hotbed of enteric, and many cases were found in the civil population.The searchl for these, in wllich the bacterio- logists were aided by the Belgian sanitary officer, Dr. de Wulf, and also by the Society of Friends, was very difficult.In one village cases of enteric oCcurred in three successive formations that were billeted there.No civil eases could be traced, until news was brought of a child that had been sent away to convalesce at a neighbouring farm.The clue was followed, and the family to whiclr the child belonged were identified as thle source of the ontbreak.They kept an estaminet, and sold food to the soldiers.Many carriers of -dysentery have--also been-discovered and isolated.The conditions of warfare made it far less possible to obtain contacts of cerebro-spinal fever at the front where med are eonstantly moving, than iS is at-home where a man may be stationary fr weeks.
MILITARY DENTAL PRACTICE—ITS MODIFICATIONS AND LIMITATIONS.
Authors: Henry D Hatch
Journal: JAMA (1901)

What shall the new military practice consist of? What are its limitations and modifications, and how must the conservative civil practice be modified so as to best serve the interests of the army and the individual soldier? These are the questions with which it is the province of this paper to deal. There are certain branches of dentistry which to-day, as it exists, it would seem wise to eliminate altogether, namely, prosthetic dentistry, orthodontia, crown and bridge work, and gold filling. Prosthetic dentistry would be impracticable for the following reasons: 1. The appliances necessary for the construction of artificial dentures are cumbersome and would add that much more to an already overburdened transport service. 2. The time required to do such work is more than could be spared, owing to the few surgeons assigned to the service. That orthodontia would have no place in military surgery is self-evident to any
Best, Quick, Link, and the Nobel Prize
Authors: IRVING S. WRIGHT
Journal: Annals of Internal Medicine (1980)

Letters1 July 1980Best, Quick, Link, and the Nobel PrizeIRVING S. WRIGHT, M.D.IRVING S. WRIGHT, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-1-153_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: It was a pleasure to see in Dr. Dirckx's short biography of Armand Quick in your April issue (1) the picture of me with Drs. Best, Quick, and Link that was taken at a symposium in recognition of the 20th anniversary of the first clinical use of heparin in the United States in 1938 (2). In that year Dr. Best brought most of his very limited supply of "purified" heparin to New York, where we treated a young man with intractable migrating thrombophlebitis for 16 days until the supply of heparin ran out; the patient's phlebitis and...References1. DIRCKX J. Armand J. Quick: Pioneer and prophet of coagulation research. Ann Intern Med. 1980;92:553-8. LinkGoogle Scholar2. WRIGHT I ed. A history of anticoagulants. Circulation. 1959;19:73-134. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: IRVING S. WRIGHT, M.D.Affiliations: 450 East 69th Street New York, NY 10021 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1980Volume 93, Issue 1_Part_1Page: 153-153KeywordsHeparin ePublished: 1 December 2008 Issue Published: 1 July 1980 PDF downloadLoading ...
Do white British children and adolescents get enough sunlight?
Authors: Brian Diffey
Journal: BMJ (2005)

T lymphocytes from cord blood and adults stimulated with mitogens and alloantigen were analyzed using monoclonal antibodies that detect Ia and Tac antigens associated with lymphocyte activation. Less than 5% of T cells freshly isolated or cultured without stimuli expressed Ia and Tac antigens assessed by the indirect immunofluorescence method. When both T cells from cord blood and adults were cultured with phytohemagglutinin (PHA), concanavalin A (Con A), pokeweed mitogen (PWM), or allogeneic cells, variable proportions of them expressed Tac antigen. The expression of Tac antigen on stimulated T cells increased in parallel with DNA synthesis, and was significantly correlated with the proliferative response of stimulated T cells. In contrast to Tac antigen, the expression of Ia antigens appeared to show some time lag behind the proliferative response. Although expression of Ia antigens was too weak to assess in PHA- or Con A-stimulated cultures, adult T cells were stimulated by PWM or allogeneic cells to express strongly Ia antigens in culture. However, the percentage of Ia+ cells in cord blood T cells stimulated with PWM or allogeneic cells was markedly lower as compared with that of adults. In addition, cord blood T cells grown in the presence of T cell growth factor showed the same degree of Tac antigen as adult ones did, whereas their expression of Ia antigens was negligible as compared with adult controls. These observations suggested that T cells in cord blood might be deficient by nature in their ability to express Ia antigens on activation. The inability to develop Ia+ T cells seemed to be characteristic of functional immaturity of T cells in early human ontogeny.
Cytochrome and arachidonic acid metabolites: Role in myocardial ischemia/reperfusion injury revisited
Authors: G GROSS, J FALCK, E GROSS, M ISBELL, J MOORE, K NITHIPATIKOM
Journal: Cardiovascular Research (2005)

Ischemia–reperfusion of the heart and other organs results in the accumulation of unesterified arachidonic acid (AA) via the action of membrane-bound phospholipases, primarily phospholipase A2. AA can be metabolized by the classical cyclooxygenase (COX) and lipoxygenase (LOX) pathways to well-characterized metabolites and their respective cardioprotective end products such as prostacyclin (PGI2) and 12-hydroxyeicosatetraenoic acid (12-HETE). However, it has only been recently recognized that another less well-characterized pathway of AA metabolism, the cytochrome P450 (CYP) pathway, may have important cardiovascular effects. Several lines of data support the possibility that certain CYP metabolites resulting from the hydroxylation of AA such as 20-hydroxyeicosatetraenoic acid (20-HETE) are potent vasoconstrictors and may produce detrimental effects in the heart during ischemia and pro-inflammatory effects during reperfusion. On the other hand, a group of regioisomers resulting from the epoxidation of AA, including 5,6-, 8,9-, 11,12- and 14,15-epoxyeicosatrienoic acid (EETs), have been shown to reduce ischemic and/or reperfusion injury in the heart and vasculature. This review will discuss the detrimental and beneficial actions, including the potential cellular mechanisms responsible as a result of stimulating or inhibiting the two arms of this novel CYP pathway. The therapeutic potential of increasing EET concentrations and/or reducing 20-HETE concentrations will also be addressed.
<i>Chlamydia pneumoniae</i> (TWAR) in Atherosclerosis of the Carotid Artery
Authors: J. Thomas Grayston, Cho-chou Kuo, Alan S. Coulson, Lee Ann Campbell, Robert D. Lawrence, Ming Jong Lee, Eugene D. Strandness, San-pin Wang
Journal: Circulation (1995)

Background Chlamydia pneumoniae has been demonstrated in atherosclerotic lesions of coronary arteries and aorta. A seroepidemiological study found C pneumoniae –specific antibody more frequently in persons with significant carotid artery wall thickening than in matched control subjects. Methods and Results Fresh-frozen or formalin-fixed tissue obtained at carotid endarterectomy was examined by immunocytochemistry (ICC) and the polymerase chain reaction (PCR) for the presence of C pneumoniae. Five of five fresh-frozen and formalin-fixed carotid endarterectomy specimens were positive for C pneumoniae by ICC (three of five by PCR). A total of 56 archival formalin-fixed, paraffin-embedded carotid endarterectomy tissues from three hospitals were examined by ICC. Thirty-two were positive. Thirteen normal carotid artery tissue sections from six patients were negative for C pneumoniae . Conclusions C pneumoniae organisms are frequently found in the advanced carotid atherosclerotic lesions of persons undergoing endarterectomy. Although these findings do not establish causality for C pneumoniae in carotid artery atherosclerosis, they should stimulate investigation of a possible causal or pathogenic role for the organism in the disease.
False-positive lung scans and radiotherapy.
Authors: N T Bateman, D N Croft
Journal: BMJ (1976)

It has been suggested that obliterative vasculitis in the lung might mimic pulmonary embolism on a ventilationperfusion scan. The combined scans of six patients with breast cancer who had undergone radiotherapy to the chest wall, which can induce pulmonary vasculitis, were therefore examined. Eleven of the 12 scans showed perfusion defects with ventilation-perfusion mismatch on the irradiated side. Special care is needed in interpreting the lung scans of patients who have received an appreciable tissue dose of radiation to the lungs; mismatch need not indicate pulmonary embolism.
Hypoxemia Is Associated With Mitochondrial DNA Damage and Gene Induction
Authors: Marisol Corral-Debrinski
Journal: JAMA (1991)

--Oxidative phosphorylation (OXPHOS) deficiency due to hypoxemia or other causes was hypothesized to increase oxygen radical generation, damage mitochondrial DNA (mtDNA), and reduce adenosine triphosphate synthesis, resulting in compensatory OXPHOS gene induction. Therefore, we investigated the levels of mtDNA damage and OXPHOS transcripts in normal and ischemic hearts, and then in other forms of heart disease.--DNA was extracted from the heart and the levels of the common 4977 base pair mtDNA deletion were quantitated as an index for mtDNA damage. Total RNA was extracted from hearts and analyzed for OXPHOS transcript levels.--In control hearts, the 4977 base pair mtDNA deletion appeared at age 40 years and reached a maximum deletion of 0.0035%. Much higher levels were found in ischemic hearts (0.02% to 0.85%), as well as in three of 10 cases with other types of heart disease (0.017% to 0.16%). The OXPHOS transcripts were increased in all diseased hearts.--Ischemic hearts have increased mtDNA damage and OXPHOS gene expression, suggesting that mtDNA damage is associated with OXPHOS deficiency. Oxidative phosphorylation defects may also play a role in some other forms of cardiac disease.
Improving Medication Use for Older Adults: An Integrated Research Agenda
Authors: Michael D. Murray, Christopher M. Callahan
Journal: Annals of Internal Medicine (2003)

Effective health care is a core determinant of successful aging, and medications are one of the most important therapeutic tools of health care providers. Most older adults use at least one prescription drug. Costs for these drugs are a substantial out-of-pocket expense for Medicare beneficiaries, and low-income older adults must weigh these costs against those of other basic needs. Although medications bring welcome relief to millions of elderly persons with age-related conditions, adverse drug events are an important cause of illness and death in these patients. Thus, the appropriate, cost-effective use of medication is central to successful aging. Despite increasing attention to geriatric pharmacotherapy, there is an enormous need for additional research to improve the use of medications among older adults. The necessary research agenda encompasses much more than just the discovery of new drugs; better use of the current pharmacopeia has great potential to improve the lives of older adults. We review four domains of pharmaceutical research: drug discovery and delivery, drug efficacy and safety, pharmacoepidemiology and drug policy, and improved access to and use of drugs. These domains encompass both the pre- and postmarketing phases of drug research. Premarketing research currently has greater magnitude and a better infrastructure than postmarketing research, yet issues arising in the two phases of research are equally important to the health and safety of older adults. A national, federally supported pharmaceutical database could greatly enhance the infrastructure of postmarketing research. However, many major improvements in medication use among older adults will also depend on closing the gap between knowledge and practice and increasing the ability of older adults to manage their medications.
Congenital rubella in babies of south Asian women in England and Wales: an excess and its causes.
Authors: E Miller, A Nicoll, S A Rousseau, P J Sequeira, M H Hambling, R W Smithells, H Holzel
Journal: BMJ (1987)

The incidence of congenital rubella was found to be 2.3 times higher in Asian than non-Asian births in England and Wales. This was attributed in part to higher susceptibility to rubella in Asian than non-Asian women, as shown by antenatal serological data from public health laboratories in Leeds, Luton, and Manchester. Examination of the ethnic origin of pregnant women requesting laboratory testing after contact with rubella or rash and of women with laboratory confirmed rubella in pregnancy also suggested that the disease was being underdiagnosed in pregnant Asian women. Failure to prevent congenital rubella by termination of infected pregnancies may therefore contribute to the increased incidence of the syndrome in Asians. Health education programmes about the dangers of rubella in pregnancy and of the need for vaccination can readily be promoted in the Asian community through existing ethnic organisations. Protection of other ethnic minorities likely to be at similar increased risk may require a vaccination programme aimed at national elimination of rubella.