tbuckley/cabot-search huggingface dataset:
Algorithmic Selection and Interpretation of Diagnostic Tests
Authors: Ruric Anderson
Journal: Annals of Internal Medicine (1998)

Medical Writings15 September 1998Algorithmic Selection and Interpretation of Diagnostic TestsRuric Anderson, MDRuric Anderson, MDMedical College of Wisconsin, Milwaukee, WisconsinSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-6-199809150-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Algorithmic Selection and Interpretation of Diagnostic Tests; Collins RD. 716 pages. Baltimore: Williams & Wilkins; 1998. $35.00. ISBN 0683304267. Order phone 800-638-0672.Field of medicine: Primary care.Format: Softcover book.Audience: Practicing clinicians and trainees.Purpose: To help the clinician select and interpret diagnostic tests in a cost-efficient manner.Content: Many diagnostic tests are described and are included in algorithms to allow evaluation of specific symptoms and confirmation of provisional diagnoses.Highlights: The listing of available tests is comprehensive, and the discussion of each test is brief but instructive. Many of the algorithms are useful forming a diagnostic strategy.Limitations: ... Author, Article, and Disclosure InformationAffiliations: Medical College of Wisconsin, Milwaukee, Wisconsin PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1998Volume 129, Issue 6Page: 512KeywordsAlgorithmsClinical laboratoriesDiagnostic medicine ePublished: 15 August 2000 Issue Published: 15 September 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Gene Deletion Contributes to the Virulence of an Outbreak Strain of Mycobacterium Tuberculosis via Immune Subversion
Authors: S.M. Newton, R.J. Smith, K.A. Wilkinson, M.P. Nicol, N.J. Garton, S. Fandrich, K.J. Staples, L. Ziegler-Heitbrock, G.R. Stewart, J.R. Wain, A.R. Martineau, A. Al-Obaid, J. Shafi, T. Smallie, K. Rajakumar, P.W. Andrew, B. Foxwell, M.R. Barer, R.J. Wilkinson
Journal: Journal of Infection (2007)
STUDIES ON THE PATHOGENESIS OF MENINGITIS. I. INTRATHECAL INFECTION*
Authors: Robert G. Petersdorf, Charles N. Luttrell
Journal: Journal of Clinical Investigation (1962)

Meningitis was produced in dogs by inoculation with 10/sup 3/10/sup 6/ type III pneumococci via the subarachnoid space. This produced an infection lasting 48-96 hrs and characterized by cerebrospinal fluid (CSF) changes, including an increase of leukocytes and bacteria and a decrease in glucose concentration. This concentration was inversely related to the cell and bacteria counts of CSF. Pretreatment for 5 dogs with prednisolone did not alter the course of infection. When leukopenia was produced by 450 r whole-body irradiation, the number of inflammatory cells in the CSF was reduced in infected animals and survival was prolonged. This indicates that exudation into the subarachnoid space may have a harmful effect on the ventricular cavities where it may cause hydrocephalus. (H.H.D.)
Carvedilol for preventing recurrent variceal bleeding: Waiting for convincing evidence
Authors: Jaime Bosch, Roberto J. Groszmann, Yasuko Iwakiri, Tamar H. Taddei
Journal: Hepatology (2013)

Abstract: Background: Carvedilol has been shown to be more effective than propranolol in decreasing portal pressure. Sufficient data from controlled trials remains limited. This trial compared the relative safety and efficacy between carvedilol and nadolol plus isosorbide mononitrate in preventing variceal rebleeding. Methods: After successful control of acute esophageal variceal bleeding, eligible patients were randomized to Carvedilol group, 61 patients, using carvedilol 6.25-12.5 mg daily or N + I group, 60 patients, using nadolol 40-80 mg plus isorsorbide-5-mononitrate 20mg daily. The end points were rebleeding from varices, adverse events or death. Results: After a median follow up of 30 months, recurrent upper gastrointestinal bleeding developed in 37 patients (61%) in the Carvedilol group and 37 patients (62%) in the N + I group (p = 0.90). Recurrent bleeding from esophageal varices occurred in 31 patients (51%) in the Carvedilol group and in 26 patients (43%) in the N + I group (p = 0.46). Recurrent bleeding from gastric varices occurred in 2 patients (3%) in the Carvedilol group and in 8 patients (13%) in the N + I group (p = 0.05). Severe adverse events occurred in 1 patient in Carvedilol group and 17 patients in N + I group (p&lt;0.0001). Fifteen patients of the Carvedilol group and 17 patients in the N + I group died (p = 0.83). Two patients in the Carvedilol group and 3 patients in N + I group died of variceal bleeding. Conclusions: Carvedilol was as effective as nadolol plus isorsorbide-5 –mononitrate mononitrate in the prevention of gastroesophageal variceal rebleeding with fewer severe adverse events and similar survival.
MicroRNA-130a–mediated down-regulation of Smad4 contributes to reduced sensitivity to TGF-β1 stimulation in granulocytic precursors
Authors: Mattias Häger, Corinna Cavan Pedersen, Maria Torp Larsen, Mette Klarskov Andersen, Christoffer Hother, Kirsten Grønbæk, Hanne Jarmer, Niels Borregaard, Jack Bernard Cowland
Journal: Blood (2011)
New study of suicides needed.
Authors: B. Barraclough
Journal: BMJ (1992)

Preventing children drowning SIR,-Three summers ago our 2 year old son wandered from our garden.He was found in the swimming pool of a neighbouring garden: the pool was unfenced and had a non-weightsbearing cover.Resuscitation was not successful.We know of three families within 16 km who have suffered similar tragedies: as Alison Kemp and J R Sibert point out, drowning is a common cause of acci- dental death in children.'In our society, where there is increased emphasis on out ofdoors activities, the incidence ofdrowning in children will surely increase unless effective preventive measures are taken.We have written on this matter to our member of parliament without success.We support Kemp and Sibert's recom- mendations that domestic pools should have toddler proof fences with self locking doors and covers that can bear the weight of a child.People may argue that this interferes with personal liberty: the same was said about seat belt legislation.The children whose lives are at risk are too young to appreciate such abstract arguments.
The ROC Curve in the Evaluation of Fasting Capillary Blood Glucose as a Screening Test for Diabetes and IGT
Authors: Aida L. Bortheiry, Domingos A. Malerbi, Laercio J. Franco
Journal: Diabetes Care (1994)

OBJECTIVE To assess the performance of different cutoff points of fasting capillary glycemia (FCG) in the diagnosis of diabetes and impaired glucose tolerance (IGT) using the receiver operating characteristics (ROC) curve approach. RESEARCH DESIGN AND METHODS This study included a sample of 4,019 subjects without a previous history of diabetes who were recruited for a confirmatory 2-h post-glucose challenge capillary glycemia from a larger sample of 21,847 individuals screened with FCG. The sensitivity and the specificity of FCG as a screening test were analyzed in the cutoff range 3.9–8.9 mmol/l, and the corresponding ROC curves were plotted to assess the performance of the test. RESULTS The screening test performance was better for diabetes than for IGT in the full range of cutoff points studied. Sensitivities ranged between 37.9 and 97.1% for diabetes and 1.8 and 94.4% for IGT; the areas under the ROC curves were 0.91 ± 0.01 and 0.75 ± 0.01, respectively. The cutoffs showing the best equilibrium between sensitivity and specificity approached 5.6 and 5.0 mmol/l for diabetes and IGT, respectively. Factors such as age, color, and family history of diabetes can affect the screening test performance. CONCLUSIONS ROC curves can provide useful information toward improving the usefulness of FCG as a screening test for abnormalities of glucose tolerance.
NHS managers call for calm in debate on polyclinics
Authors: Rob Finch
Journal: BMJ (2008)

The NHS Confederation last week called on interested parties to keep calm and consider the evidence when evaluating the proposal for polyclinics made by the health minister Ara Darzi last summer ( BMJ 2007;335:61; doi: 10.1136/bmj.39273.467697.DB).

Its report was attacked by opposition politicians for “missing the point” and was criticised by senior GPs.

The confederation’s anonymous report blames “misconceptions” about polyclinics for impeding the consideration of their benefits. Far from disrupting continuity of care or undermining general practice, it says, polyclinics can improve access as well as allow patients to see their own doctor.

The confederation …
ABO phenotypes and inflammation-related predictors of lung cancer mortality: the Copenhagen Male Study - a 16-year follow-up
Authors: P. Suadicani, H. O. Hein, F. Gyntelberg
Journal: European Respiratory Journal (2007)

Inflammation and genetic susceptibility influence the risk of lung cancer. Previous studies suggest that the inflammatory response may depend upon ABO phenotype. The hypothesis that the association with lung cancer mortality risk of lifestyle and occupational factors previously linked to inflammation would depend upon ABO phenotype was tested in a long-term follow-up of 3,346 male subjects aged 53–74 yrs. During a 16-yr period, 170 (5.1%) of the male subjects died due to lung cancer; 84 (5.9%) of phenotype O, 70 (4.9%) of phenotype A and 16 (3.2%) of phenotype B/AB. In addition to cumulative tobacco consumption, high salt intake long-term occupational dust exposure, high fat intake and consumption of alcohol were significantly predictive of lung cancer mortality for phenotype O subjects. After multivariable adjustment, the hazard ratios associated with the first three of these factors were 2.31, 2.08 and 1.67, respectively. Compared with abstainers, the hazard ratios for males drinking 1–10 wine drinks·week −1 and males drinking &gt;10 wine drinks·week −1 were 1.65 and 2.02, respectively. Among phenotype A subjects, only cumulative tobacco consumption was associated with lung cancer mortality risk. The predictive role of inflammation-related risk factors for lung cancer mortality was significantly stronger among males of phenotype O than A.
Joan Elizabeth Bamji (nee Jermyn)
Authors: A. Bamji
Journal: BMJ (2011)

Born in Kings Lynn into a staunch Methodist family, Joan Elizabeth Bamji (nee Jermyn) (“Betty”) was educated at Benenden (which she hated), her fees paid by her uncle, whose wife had been at the wheel when her father died in a road accident. As a left wing physiology graduate in London before the second world war, she sold …
ABC of Medical Computing: DIGITAL IMAGING
Authors: H. B Meire, A. Darzi, N. Lee
Journal: BMJ (1995)

Kodak digital camera system based onNikon F90 camera.Pictures have been traditionally taken with photographic film, which then has to be processed before they can be viewed.The development of digital cameras now allows pictures to be taken and printed almost immediately.In medicine this can be an important advantage, and, even though the quality of digital images is currently lower than that of photographic film, the huge advantage of immediate images often far outweighs the slight loss of resolution.Digital cameras are now available to replace the standard 35 mm camera for taking routine clinical photographs as well as for use in specialised areas of medicine.
Treatment of Zenker’s diverticulum through a flexible endoscope with a transparent oblique-end hood attached to the tip and a monopolar forceps
Authors: P. Christiaens, W. De Roock, A. Van Olmen, V. Moons, G. D'Haens
Journal: Endoscopy (2007)

Zenker's diverticulum was commonly treated by means of external transcervical diverticulectomy, myotomy or diverticulopexy, or by means of an endoscopic myotomy through a rigid endoscope. Gastroenterologists first described flexible endoscopic therapy for Zenker's diverticulum in 1995. In our single-center study we report the safety and feasibility of endoscopic myotomy through a flexible endoscope, performed at a secondary referral centre.A series of 21 patients with Zenker's diverticulum were treated using a flexible endoscope with a transparent oblique-end hood attached to the tip and a monopolar coagulation forceps. Relief of the dysphagia was the main outcome measure with evaluation of safety and complications. Dysphagia was graded on a scale of 0 to 4 before and after treatment. General anesthesia was not used.Access to the esophagus was attained without problems in all patients. Oral feeding was resumed the following day. Complete relief of dysphagia was reported by all patients after 1 month. Dysphagia recurred in two patients (9.5%) after the first session. These patients were successfully treated again in the same way. Adverse events were limited to transient cervical emphysema in a single patient.This endoscopic technique is an efficient, safe and minimally invasive method for the treatment of Zenker's diverticulum. General anesthesia is not necessary and oral feeding can be resumed the next day. In view of the excellent results and minimal complications, it can be considered a safe alternative for the treatment of Zenker's diverticulum.
Anti-inflammatory effects of systemic anti-tumour necrosis factor alpha treatment in human/murine SCID arthritis
Authors: H. Schadlich, J. Ermann, M. Biskop, W. Falk, F. Sperling, A. Jungel, J. Lehmann, F. Emmrich, U. Sack
Journal: Annals of the Rheumatic Diseases (1999)

To evaluate in vivo the contribution of tumour necrosis factor alpha (TNFalpha) to the chimeric transfer model of human rheumatoid arthritis synovial membrane into SCID mice (hu/mu SCID arthritis), systemic anti-TNFalpha treatment was performed and the clinical, serological, and histopathological effects of this treatment assessed.Animals were treated with the rat-antimouse TNFalpha monoclonal antibody V1q, starting on day 1 after hu/mu engraftment, twice weekly for 12 weeks. Joint swelling, serum concentrations of human and murine interleukin 6 (IL6), and serum amyloid P (SAP) were measured. Histopathological and immunohistochemical analyses of the joints were also performed at the end of treatment.Neutralisation of murine TNFalpha induced the following effects: (a) reduction of extent and duration of the acute arthritis phase, with significant reduction of joint swelling at two weeks; (b) decrease of murine SAP concentrations after the first antibody administration; and (c) increase of murine IL6 in the serum. At the end of treatment, there was a significant reduction of the inflammatory infiltration in the engrafted joints. Because of the mild degree of joint erosion, no treatment effects could be demonstrated on the destructive process.In the lymphocyte independent hu/mu SCID arthritis, anti-TNFalpha treatment reduces local and systemic signs of inflammation.
Glanmor Rhys Davies
Authors: M. Davies, P. Davies
Journal: BMJ (2008)

Glanmor Rhys Davies died peacefully on 4 May 2008 at Glyneiddan, his home for the past 47 years. He was born in 1915 in Tonypandy, Rhondda Fawr, his paternal grandparents having migrated there from north Pembrokeshire in 1880 at the time of the massive expansion in the coal industry in …
Traumatic Dislocation of the Hip in a Child
Authors: Raymond G. Tronzo
Journal: JAMA (1961)

A 10-YEAR-OLD BOY with a traumatic anterior dislocation of the hip presented a problem in anesthesia. Traumatic dislocation of the hip in children<sup>1</sup>is not only rare but is also serious.<sup>2</sup>From a recent study conducted by the Pennsylvania Orthopedic Society, only 96 such cases have been reported in the literature, and anterior dislocations are even more unusual.<sup>3</sup>In this case, the child sustained a cerebral concussion which made the situation more complex. <h3>Injury</h3> While playing in a tree, the boy slipped and fell about 25 ft. to the ground. He was unconscious for a short but unknown period. Severe pain and deformity of the right hip made walking impossible. Upon admission to the hospital, the child was in obvious distress. His right thigh was locked at almost a right angle to the trunk and was externally rotated. The knee was flexed. A hard, bulging mass was
Nondirected Donation of Kidneys from Living Donors
Authors: A J Matas, C A Garvey, C L Jacobs, J P Kahn
Journal: New England Journal of Medicine (2000)

The transplantation of organs from living donors has always involved a balancing of the physical risks and psychological benefits to the donor against the benefits to the recipient. Early in the history of transplantation, the expectation was that the outcomes for recipients of transplants from living unrelated donors and for recipients of cadaveric transplants would be similar and that the risks to unrelated living donors would therefore not be justified.As the outcome of kidney transplantation improved and the criteria for accepting patients for transplantation were expanded, greater numbers of patients with end-stage renal failure opted for transplantation rather than . . .
Glucagon for Propranolol Overdose
Authors: Richard C. Smith
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Acute ingestions of massive doses of propranolol hydrochloride have potentially lethal outcomes. The most common reported presenting signs and symptoms are hypotension, bradycardia, generalized seizures, and the sudden appearance of these symptoms in a previously stable patient who may appear misleadingly well.<sup>1,2</sup>Increasingly, evidence suggests that glucagon should be the mainstay of therapy in severe β-blocker overdose.<sup>1,3</sup>We report a case of propranolol overdose successfully treated with glucagon in a large metropolitan area in which the supply of glucagon was limited. <h3>Report of a Case.—</h3> A 29-year-old woman drove herself to the emergency room 30 minutes after ingesting forty 80-mg propranolol hydrochloride tablets in an apparent suicide attempt. Physical examination revealed an alert, oriented, ambulatory woman who was somewhat depressed and stating that she "did not know what she had done." The patient's vital signs were initially stable, with a pulse rate of 93 beats
Prognosis and staging of non-alcoholic fatty liver disease
Authors: P. Jepsen, H. Gronbaek
Journal: BMJ (2011)

<h3>Abstract</h3> <h3>Objective</h3> To investigate the clinical effectiveness and safety of stand alone and blended internet based vestibular rehabilitation (VR) in the management of chronic vestibular syndromes in general practice. <h3>Design</h3> Pragmatic, three armed, parallel group, individually randomised controlled trial. <h3>Setting</h3> 59 general practices in the Netherlands. <h3>Participants</h3> 322 adults aged 50 and older with a chronic vestibular syndrome. <h3>Interventions</h3> Stand alone VR comprising a six week, internet based intervention with weekly online sessions and daily exercises (10-20 minutes a day). In the blended VR group, the same internet based intervention was supplemented by face-to-face physiotherapy support (home visits in weeks 1 and 3). Participants in the usual care group received standard care from a general practitioner, without any restrictions. <h3>Main outcome measures</h3> The primary outcome was vestibular symptoms after six months as measured by the vertigo symptom scale-short form (VSS-SF range 0-60, clinically relevant difference ≥3 points). Secondary outcomes were dizziness related impairment, anxiety, depressive symptoms, subjective improvement of vestibular symptoms after three and six months, and adverse events. <h3>Results</h3> In the intention-to-treat analysis, participants in the stand alone and blended VR groups had lower VSS-SF scores at six months than participants in the usual care group (adjusted mean difference −4.1 points, 95% confidence interval −5.8 to −2.5; and −3.5 points, −5.1 to −1.9, respectively). Similar differences in VSS-SF scores were seen at three months follow-up. Participants in the stand alone and blended VR groups also experienced less dizziness related impairment, less anxiety, and more subjective improvement of vestibular symptoms at three and six months. No serious adverse events related to online VR occurred during the trial. <h3>Conclusion</h3> Stand alone and blended internet based VR are clinically effective and safe interventions to treat adults aged 50 and older with a chronic vestibular syndrome. Online VR is an easily accessible form of treatment, with the potential to improve care for an undertreated group of patients in general practice. <h3>Trial registration</h3> Netherlands Trial Register NTR5712.
RT-33 * OUTCOME OF GLIOBLASTOMA IN THE POST-STUPP ERA: A SINGLE CENTRE RETROSPECTIVE AUDIT
Authors: R. Tresman, J. Wright, C. Dubois, J. Lewis, S. Surash
Journal: Neuro-Oncology (2014)

BACKGROUND: Glioblastoma is the most common primary brain tumour in adults. Prior to the introduction of the Stupp protocol an audit by the Northern Centre for Cancer Care (NCCC) found a mean survival time of 12.4 months [1] using the standard regime at the time of radiotherapy alone (comparing favorably to Stupp control group under the same regime). However in 2005, Stupp et. al demonstrated an increase in mean survival time in their data from 12.1 months to 14.6 months with a new regime of radical radiotherapy with concurrent and adjuvant chemotherapy using temozolomide [2]. In 2009/2010 this protocol was implemented locally. AIMS: Assess whether expected life expectancy is being achieved as per the Stupp chemoradiotherapy regime standard [2]. METHODS: Retrospective study with data from electronic notes of 105 consecutive patients over 18 years of age who began radical therapy for glioblastoma (Grade 4) between December 2009 – December 2013. Mean survival calculated from surgery date of patients. Age range of the patients was 19-70 years with a median age of 54.85 years. RESULTS: Mean survival time 19 months (±2.3) (range: 4-44+ months). 6, 12, 18 and 24 month survival times were 92.8%, 71.9%, 50.4% and 35.8% respectively. CONCLUSIONS: Mean survival time and 6, 12, 18 and 24 month percentage survival exceeds Stupp data and previous departmental audit, demonstrating the success of the unit.