tbuckley/cabot-search huggingface dataset:
Acute Jejunal Perforation
Authors: Leonard E. Reaves
Journal: JAMA (1965)

<h3>To the Editor:—</h3> Arteriosclerotic aneurysms of the abdominal aorta are being treated successfully by resection of the involved segment and the reestablishment of continuity with prosthetic grafts. Recent reports describing the long-term results have directed attention to the serious and possibly preventable late sequelae, such as erosion of the retroperitoneal portion of the duodenum by the aortic replacement,<sup>1</sup>aortic-enteric fistula,<sup>2</sup>intestinal ischemic necrosis,<sup>3</sup>and small bowel obstruction. This communication concerns a patient in whom an acute perforation of the jejunum developed 12 months after removal of an aneurysm as the result of silent pressure necrosis of the portion of bowel adherent to the Dacron graft. A 58-year-old housewife had a fusiform abdominal aortic aneurysm resected and replaced by a Dacron graft of the bifurcation type. Twelve months later she experienced a sudden episode of knifelike periumbilical pain, nausea, sweating, and profound weakness which lasted 12 hours. Surgical
Shadow health secretary defends Labour's record on health
Authors: A. Gulland
Journal: BMJ (2011)

The Labour shadow health secretary, John Healey, has denied that the government’s plans are a logical extension of Labour’s policy of increasing private sector involvement in the NHS.

Mr Healey, who was giving his response to the Health and Social Care Bill ( BMJ 2011;342:d418, doi:10.1136/bmj.d418) at a King’s Fund debate on 20 January, said that the Labour government had invited private sector providers to deliver healthcare only as a means of getting waiting lists down or providing additional choice for patients.

“We accepted, supported, …
Airway remodeling is correlated with obstruction in children with severe asthma
Authors: I. Tillie‐Leblond, J. De Blic, F. Jaubert, B. Wallaert, P. Scheinmann, P. Gosset
Journal: Allergy (2008)

Background: Severe asthma may involve an irreversible obstructive pattern, and structural changes in bronchial airways are believed to play a key role in this context. The aim of the present study was to compare airway remodeling in severe asthmatic children with or without obstructive pattern. Methods: Two groups of children with severe asthma and persistent symptoms, 5–14 years old were included, 15 with persistent obstructive pattern (group O) and 10 without obstructive pattern (group N). Persistent obstructive pattern was defined as a forced expiratory volume in 1 s (FEV 1 ) less than 80% of the predicted value after a course of systemic corticosteroids and no significant improvement after bronchodilator. We examined bronchial biopsies by pathological and immunochemical methods and quantified airway smooth muscle (ASM) and mucus gland areas, reticular basement membrane (RBM) thickening, distance between ASM and RBM, muscle light chain kinase (MLCK) expression and number of vessels (CD31 expression). Results: Surface area of ASM ( P = 0.009), MLCK expression ( P = 0.03) and number of vessels ( P = 0.0008) were increased in group O compared with group N. Distance of RBM–ASM was shorter in group O ( P = 0.007). FEV 1 negatively correlated with ASM area ( r = −0.6; P = 0.002), MLCK expression ( r = −0.45; P = 0.02) and CD31 expression ( r = −0.7; P = 0.0003), and positively correlated with the distance of RBM–ASM ( r = 0.5; P = 0.007). Conclusions: Structural abnormalities of airway remodeling are present in children with severe asthma. Only an increase in surface area of ASM and the density of the vascular network are more pronounced in children with persistent obstructive pattern, while RBM thickening is similar. These results are concordant with longitudinal studies which emphasize the precocity of bronchial obstruction.
Sword swallowing uncertainties
Authors: Brian Witcombe
Journal: BMJ (2005)

doing the state's dirty work.But the opposite is true.To conceal policies that dictate rationing is to collude in the state's silence.Most doctors wish to practise medicine ethically.Ensuring that patients have access to policies that might affect them is an important aspect of ethical practice.I thank Elisabeth Hartley and Andrew Smith for their helpful comments.Contributors and sources: CW is a patient representative.She is particularly concerned with elucidating the ways in which patients' individual and collective
Mechanisms for impulse initiation in isolated human atrial fibers.
Authors: L Mary-Rabine, A J Hordof, P Danilo, J R Malm, M R Rosen
Journal: Circulation Research (1980)

We used standard microelectrode techniques to study Tyrode's-superfused human atrial fibers obtained at cardiac surgery.Two types of sustained rhythmic activity occurred.One resulted from slow phase 4 depolarization and had a spontaneous rate = 20-26 beats/min.Epinephrine increased and the slow channel blockers, AHR-2666 (AHR) and verapamil decreased both phase 4 slope and spontaneous rate.Acetylcholine (ACh) and lidocaine decreased the slope of phase 4, but the slowing of rate was less than that induced by AHR and verapamil.Tetrodotoxin (TTX) also decreased the slope of phase 4 and spontaneous rate, to an extent that was intermediate between the actions of AHRverapamil and ACh-lidocaine.A second type of sustained rhythmic activity was triggered by delayed afterdepolarizations (DAD).DAD amplitude increased as stimulus cycle length decreased and, at critical cycle lengths, DAD initiated trains of spontaneous action potentials at rates > 70 beats/min.Spontaneously occurring DAD were suppressed by AHR and were transiently diminished by ACh.This effect of ACh was accompanied by hyperpolarization of the fibers.DAD also were induced by epinephrine.These DAD were unaffected by TTX, lidocaine, or ACh and were suppressed by AHR and verapamil.In summary, the slow inward current contributes to the sustained rhythmic activity that occurs with automaticity or DAD in human atrium.A TTX-sensitive current also contributes to automaticity.DAD that occur spontaneously are largely insensitive to the effects of agents that increase K conductance (although ACh has a transient effect) and those that are induced in the presence of epinephrine do not respond to agents which increase K conductance (ACh, lidocaine) or TTX.
Life-Sustaining Therapy
Authors: Donald J. Murphy
Journal: JAMA (1990)

New strategies are needed to curb the proliferation of life-sustaining therapies that rarely benefit patients. We propose a model for appropriate use of such therapies that incorporates effectiveness, utility, and marginal costs. If a therapy is rarely effective and rarely desirable, it is considered medically inappropriate. If the marginal cost-effectiveness ratio is inordinately high, it is considered economically inappropriate. If a therapy is either medically or economically inappropriate, it should not be automatically offered. The model provides an operational definition of futility and is illustrated with an analysis of out-of-hospital cardiopulmonary resuscitation for chronically ill older people. Advance directives, explicit health care rationing, and defining futile therapy based on survival predictions are alternatives to the appropriate care model, but are insufficient strategies to solve the problem of inappropriate life-sustaining care. (<i>JAMA</i>. 1990;264:2103-2108)
A Population-based Study of Diabetes Mortality
Authors: James W Ochi, L Joseph Melton, Pasquale J Palumbo, Chu-Pin Chu
Journal: Diabetes Care (1985)

In a population-based investigation among the residents of Rochester, Minnesota, the diabetes mortality rate was 8.5 per 100,000 person-years with diabetes as the underlying cause of death, 31.5 per 100,000 person-years with diabetes as an underlying or contributory cause, and 82.7 per 100,000 person-years if all deaths among diabetic individuals were counted. Diabetes was not mentioned on the certificate in 62% of the 428 diabetic deaths during 1965–1974. When the clinical characteristics of the subgroup of mortality cases in 1969 were compared with those of the prevalence cases on 1 January 1970, it was found that mortality cases tended to be older, were more often on insulin therapy, and were more likely to have macro- and microvascular complications. Because mortality data are sometimes used to infer trends and characteristics for the diabetic population at large, it is important to recognize these biases.
Clinical relevance of sensitization to lupine in peanut‐sensitized adults
Authors: K. A. B. M. Peeters, S. J. Koppelman, A. H. Penninks, A. Lebens, C. A. F. M. Bruijnzeel‐Koomen, S. L. Hefle, S. L. Taylor, E. Van Hoffen, A. C. Knulst
Journal: Allergy (2008)

The use of lupine in food has been increasing during the last decade and allergic reactions to lupine have been reported, especially in peanut-allergic patients. The frequency and the degree of cross-reactivity to other legumes are not known. The aim of the study was to investigate the frequency of sensitization to lupine, and in addition to pea and soy, and its clinical relevance, in peanut-sensitized patients. Furthermore, to determine the eliciting dose (ED) for lupine using double-blind placebo-controlled food challenges (DBPCFC).
ORAL ADMINISTRATION OF PANCREATIC PREPARATIONS
Authors: R. D. Lawrence
Journal: BMJ (1928)

<h3>Abstract</h3> Recent advances in genome sequencing and imputation technologies provide an exciting opportunity to comprehensively study the contribution of genetic variants to complex phenotypes. However, our ability to translate genetic discoveries into mechanistic insights remains limited at this point. In this paper, we propose an efficient knockoff-based method, GhostKnockoff, for genome-wide association studies (GWAS) that leads to improved power and ability to prioritize putative causal variants relative to conventional GWAS approaches. The method requires only Z-scores from conventional GWAS and hence can be easily applied to enhance existing and future studies. The method can also be applied to meta-analysis of multiple GWAS allowing for arbitrary sample overlap. We demonstrate its performance using empirical simulations and two applications: (1) analysis of 1,403 binary phenotypes from the UK Biobank data in 408,961 samples of European ancestry, and (2) a meta-analysis for Alzheimer’s disease (AD) comprising nine overlapping large-scale GWAS, whole-exome and whole-genome sequencing studies. The UK Biobank analysis demonstrates superior performance of the proposed method compared to conventional GWAS in both statistical power (2.05-fold more discoveries) and localization of putative causal variants at each locus (46% less proxy variants due to linkage disequilibrium). The AD meta-analysis identified 55 risk loci (including 31 new loci) with ~70% of the proximal genes at these loci showing suggestive signal in downstream single-cell transcriptomic analyses. Our results demonstrate that GhostKnockoff can identify putatively functional variants with weaker statistical effects that are missed by conventional association tests.
Sterilization of Surgical Rubber Gloves
Authors: W. J. Stuart
Journal: BMJ (1942)

The article by Sanford and Cookson in the Journal of March 28 (p.412) contains certain unanswered ques- tions, and makes me wonder whether it may not be of interest and use to surgeons to have some almost entirely practical figures on the methods and results of sterilization of rubber gloves, derived from the individual life-history
No Association of Antibodies to Glutamic Acid Decarboxylase and Diabetic Complications in Patients With IDDM
Authors: Ursula Roll, Axel Nuber, Anja Schröder, Evelin Gerlach, Hans-U Janka, Anette-G Ziegler
Journal: Diabetes Care (1995)

To evaluate the association of antibodies to glutamic acid decarboxylase (GAD-ab) and diabetic complications (neuropathy, retinopathy, and nephropathy) in patients with insulin-dependent diabetes mellitus (IDDM).We examined the prevalence of GAD-ab (immunoprecipitation assay) and islet cell antibodies (ICAs) (indirect immunofluorescence) in a representative sample of IDDM patients (n = 146) with different disease duration (2-52 years, median 13.2 years). Of all patients characterized for the existence of diabetic complications, 56 of 146 had peripheral neuropathy, 24 of 142 had autonomic neuropathy, 67 of 141 had retinopathy, and 39 of 146 had nephropathy.GAD-ab (> 2 SD) were detected more frequently than ICA (> 5 Juvenile Diabetes Foundation units) in IDDM patients of different disease duration (GAD-ab+ 37% [54 of 146] vs. ICA+ 22% [32 of 146], P = 0.011; diabetes duration less than median: GAD-ab+ 47% vs. ICA+ 23%, P = 0.0046; diabetes duration greater than median: GAD-ab+ 27% vs. ICA+ 22%, P > 0.05). For GAD-ab and for ICA, respectively, no difference was observed in frequency of positivity or titers between patients with or without diabetic complications.Both GAD-ab and, to a lesser extent, ICA persist for a long time in several individuals. This persistence is not related to diabetic neuropathy or any other diabetic complication.
Atypical "Influenzal Pneumonia" at a School
Authors: H. G. J. Herxheimer, A. J. McMillan
Journal: BMJ (1942)

ATYPICAL " INFLUENZAL PNEUMONIA" MEDBRITS 513 inhalational pneumonia 'or lung abscess.For the guillotine operation in children ethyl chloride is used, and for dissection in children a short ether anaesthesia.The children are given 1 to 2 grains (according to age) of seconal an hour before operation, and one hopes that this will obliterate any memory of the operation.Again we find the improvement in statistics since our specialist anaesthetist has been appointed for this purpose.Many years ago, when changing house-surgeons gave the anaesthetics, we had two or three fatalities, but for five years since this anaesthetist has been doing the work we have had none.The conclusion is that the appointment of special surgeons and anaesthetists has raised the standard of tonsillectomy to a very high level.
Lasker Awards Honor Medical Researchers, Huntington's Awareness Advocate, Lawmaker
Authors: Phil Gunby
Journal: JAMA (1993)

PROTEIN TRANSLOCATION, white blood cell regulatory hormones, Huntington's disease, and health-related legislation are highlighted in this year's Lasker awards. The awards were presented by the Albert and Mary Lasker Foundation last Friday at the annual presentation luncheon in New York, NY. The recipients were announced a day earlier at a New York news conference. <h3>Basic Medical Research</h3> Günter Blobel, MD, PhD, the John D. Rockefeller, Jr, Professor at the Rockefeller University and Howard Hughes Medical Institute, New York, NY, is the recipient of the $25 000 Albert Lasker Basic Medical Research Award. A dominant figure in the study field of protein translocation across cellular membranes, his work has addressed the "signal hypothesis"—the cell's capacity to organize itself into compartments while using just one mechanism for protein production. His efforts have led to identification of the signal sequence-gated protein transporting channel, signal recognition particle and receptor, and signal peptidase enzymes that
A CASE OF RELAPSING PHLYCTENULAR DERMATITIS OF THE EXTREMITIES (DORE).
Authors: W. N. GOLDSMITH
Journal: British Journal of Dermatology (1937)

Journal Article A CASE OF RELAPSING PHLYCTENULAR DERMATITIS OF THE EXTREMITIES (DORE). Get access W. N. GOLDSMITH, M.D., F.R.C.P. W. N. GOLDSMITH, M.D., F.R.C.P. Assistant Physician, Skin‐Department, University College Hospital Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 49, Issue 7, 1 July 1937, Pages 293–298, https://doi.org/10.1111/j.1365-2133.1937.tb10454.x Published: 01 July 1937
Engagement of major histocompatibility complex class II molecules induces sustained, lymphocyte function-associated molecule 1-dependent cell adhesion.
Authors: W Mourad, R S Geha, T Chatila
Journal: The Journal of Experimental Medicine (1990)

Antigenic stimulation is associated with enhanced adhesion between T cells and antigen-presenting cells (APC). Binding of ligands to the T cell antigen receptor activates the adhesion function of lymphocyte function-associated molecule 1 (LFA-1; CD11a/CD18). We demonstrate here that ligand binding to major histocompatibility complex class II (Ia) molecules also activates LFA-1 function, providing a reciprocal mechanism for the induction of adhesion between T cells and Ia+ APC. Adhesion was affected by a qualitative change in LFA-1 molecules and was reversed by the protein kinase C inhibitor sphingosine. These results define a novel role for Ia molecules as signal transducing receptors that regulate LFA-1-dependent adhesion via a putative, Ia-coupled protein kinase(s).
Muscle changes in acromegaly.
Authors: M Nagulesparen, R Trickey, M J Davies, J S Jenkins
Journal: BMJ (1976)

Muscle biopsy specimens were obtained from 18 patients with acromegaly of varying degrees of severity. Half the specimens showed hypertrophy of type 1 fibres, while atrophy was most often seen in type 2 fibres. A direct correlation between muscle appearances and growth hormone levels was not observed. The needle biopsy technique is particularly suitable for determining the natural history of acrometalic myopathy.
European Commission to publish a code of practice for websites
Authors: R. Watson
Journal: BMJ (2002)

The European Commission is aiming to publish a code of good practice for health websites in June. This will contain a set of criteria for quality and is part of a wider programme to clarify the legal aspects of online information and promote best practice.

The importance of health related websites is underlined by Erkki Liikanen, the commissioner of the information society when he noted recently that “more internet users have sought medical information …
Decreased lodine-123 IMP Caudate Nucleus Uptake in Patients with Huntington??s Disease
Authors: JAMES S. NAGEL, KEITH A. JOHNSON, MASANORI ICHISE, ROBERT J. ENGLISH, THOMAS M. WALSHE, JAMES H. MORRIS, B LEONARD HOLMAN
Journal: Clinical Nuclear Medicine (1988)

To determine whether I-123 isopropyl iodoamphetamine (IMP) uptake is reduced in the basal ganglia of patients with Huntington's disease compared with that in aged-matched normal and abnormal control subjects, a caudate ratio was defined that compared the average separation (in pixel units) between the midline and the left and right caudate heads to the width of the brain as measured on transaxial cross-sections of I-123 IMP SPECT brain images. For six patients with Huntington's disease, the average caudate ratio was 29.0% (SD ± 2.7%), significantly higher than that for 12 normal volunteer subjects (average caudate ratio, 19.1% ± 3.5%; p<0.001) and 13 patients with a variety of other neurologic disorders (average caudate ratio, 19.3 ± 2.2%; p<0.001).
Treating Jaundice in Neonates
Authors: Thomas C. Washburn
Journal: JAMA (1972)

To the Editor.—  I want to add a practical suggestion to the recommendations of Arias concerning jaundice in neonatal infants ( 218 :746, 1971).  While I was in private pediatric practice in Baltimore, I became an advisor to the LaLeche League. One problem that intrigued me greatly was how to manage the jaundiced infants of breast feeding mothers. Dr. Gerald Odell and I hit upon the idea of alternating feedings with breast milk and cows milk formula. This regimen worked out very well in allowing the bilirubin level to fall without any other treatment. Furthermore, this procedure alleviates the anxiety of the breast feeding mother because she is not subjected to stopping breast feeding for five to six days.
Using MEDLINE to Solve Clinical Problems-Reply
Authors: Donald A. B. Lindberg
Journal: JAMA (1993)

In Reply.  —The NLM does not plan to cope with progress in science by putting on-line the entirety of its holdings. Even so, during the past 5 years, 300 new journal titles have been added to MEDLINE and the average number of articles indexed has increased from 250 000 to 400 000 per year.  With respect to MEDLINE and Index Medicus specifically, as Dr Fink suggests, NLM is highly selective in choosing publications for inclusion. Our goal is to include only journals of high quality and relevance to the science and practice of medicine. Our choices are informed by the judgments of expert advisory bodies who in turn seek formal opinions from professional societies and associations. As in the similar process for reviewing research grant proposals, the great majority of items approved are truly worthy, yet not all worthy items are selected for inclusion, and an error in judgment occurs
Evaluation of Atrial Electromechanical Delay and its Relationship to Inflammation and Oxidative Stress in Patients with COPD
Authors: Gurkan Acar, Hasan Kahraman, Murat Akkoyun, Metin Kilinc, Cemil Zencir, Edagani Yusufoglu, Imran Dirnak, Hatice Sahin, Soner Olmez, Idris Ardic
Journal: Journal of the American College of Cardiology (2013)
Loss of Akt1 Leads to Severe Atherosclerosis and Occlusive Coronary Artery Disease
Authors: Carlos Fernández-Hernando, Eric Ackah, Jun Yu, Yajaira Suárez, Takahisa Murata, Yasuko Iwakiri, Jay Prendergast, Robert Q. Miao, Morris J. Birnbaum, William C. Sessa
Journal: Cell Metabolism (2007)
Focally Increased Activity in the Lateral Aspect of the Mid Cervical Spine on Bone Scintigraphy Is Almost Always Benign in Nature
Authors: Dong Wook Kim, Suk Chul Kim, Borys R. Krynyckyi, Josef Machac, Chun K. Kim
Journal: Clinical Nuclear Medicine (2005)

Abnormal bone scan findings in the spine are often nonspecific. The confidence level for the differential diagnosis between metastases and benign or degenerative changes may vary depending on their appearance, location or intensity. The recognition of a specific pattern for certain benign conditions and its subcategorization will increase the credibility of bone scan interpretation while retaining a high level of sensitivity. We report one such finding, focally increased activity on the lateral side of the cervical spine on the posterior view, most common at the C3-C5 level ("mid-cervical-lateral-focus").Of 481 patients with various cancers who had at least 2 whole-body bone scans, 6 months or more apart, 41 patients were judged to show this characteristic "mid-cervical-lateral-focus" on at least one scan. Final diagnosis (metastasis vs. benign) for each "mid-cervical-lateral-focus" was made based on clinical grounds and serial bone scans.The bone scan showed definite multiple metastases in 15 patients, and the differential diagnosis for the "mid-cervical-lateral-focus" was already clinically irrelevant in these patients. Nevertheless, the "mid-cervical-lateral-focus" was finally judged to be benign in 14 of these 15 patients and in all remaining 26 patients without other obvious metastases. The only "mid-cervical-lateral-focus" judged to be a metastatic focus was not only clinically redundant, but also the most intense among all the "mid-cervical-lateral-foci." in this series (too intense to be interpreted as benign).The typical "mid-cervical-lateral-focus" pattern is extremely unlikely to represent metastases (virtually 0% in patients without other obvious metastases). This knowledge helps exclude metastases on bone scans.