tbuckley/cabot-search huggingface dataset:
John Loesch, Discoverer of Renovascular Hypertension, and Harry Goldblatt: Two Great Pioneers in Circulation Research
Authors: Bernhard Glodny, Dorothea E. Glodny
Journal: Annals of Internal Medicine (2006)

In 1934, Harry Goldblatt and colleagues published an article titled "The Production of Persistent Elevation of Systolic Blood Pressure by Means of Renal Ischemia" in the Journal of Experimental Medicine. One year earlier, John Loesch had published a similar study in a German-language journal, Zentralblatt für Innere Medizin. His article appeared on 18 and 25 February 1933, in 3 parts, under the title "A Contribution to Experimental Nephritis and to Arterial Hypertension." The central proposition of both papers was the same: Renal ischemia causes persistent hypertension. Goldblatt's article is one of the best known in the history of medicine, and the words "Goldblatt kidney" are still commonly used. Although Loesch succeeded in producing persistent hypertension by inducing ischemia and in correctly interpreting this and its ramifications earlier than Goldblatt, his article has been cited only a few times. In this article, the authors share what is known about the studies of Loesch and of Goldblatt. They believe that both Loesch and Goldblatt should receive equal credit for these important first observations.
P2-12-11: Clinical Relevance of a IL-8/B-Cell Gene Signature Identified from Triple Negative Breast Cancer (TNBC) in Intrinsic Breast Cancer Subtypes.
Authors: A Rody, U Holtrich, E Ruckhaeberle, J Radosa, I Juhasz-Boess, EF Solomayer, M Kaufmann, T Karn
Journal: Cancer Research (2011)

Abstract Background: As presented recently (SABCS 2010, #S5-5) a ratio of high B-cell and low IL-8 metagenes using gene expression analysis identified 32 % of triple negative breast cancers with good prognosis and was the only significant predictor in multivariate analysis including routine clinicopathological variables. However, the clinical relevance of this signature within the intrinsic breast cancer subtypes still remains unclear and is analyzed here. Methods: Affymetrix gene expression data from n=2417 breast cancer patients have been assembled. We performed an unsupervised analysis to define metagenes that distinguish molecular subsets within TNBC (SABCS 2010, #S5-5). A high expression of B- cell metagenes was associated with good and high expression of IL-8-related metagenes were associated with poor prognosis. To identify intrinsic subtypes we used the method previously described by Hu et al. (2006) and the prognostic value within those subtypes was assessed by analyzing the event free survival of patients as function of high and low B-cell/IL-8 metagene ratio. Results: Comparing ER positive with ER negative patients the B-ceh7LL-8 ratio showed only in ER negative breast cancer a significant prognostic value (log rank p-value &amp;lt;.0001). Within the entire cohort 37.8 % of patients could be assigend to luminal A, 35.2 % to luminal B, 7,4 % to erbB2 and 19.6 % to basal-like subtypes. Event free survival of patients with good or poor B-cell/IL-8 ratio showed only in basal-like breast cancer patients a statistical significant difference (p&amp;lt;.0001). However, we could not observe any difference in prognosis in luminal A and B, as well as erbB2 tumors. No difference in the expression of the proliferation metagene was observed when samples of the intrinsic subtypes were stratified according to the prognostic predictor based on high expression of the B-Cell metagene and low expression of the IL-8 metagene. Conclusion: The B-cell/IL-8 ratio is highly prognostic in basal-like/TNBC and shows no association with proliferation status. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-11.
Norman Stanwell (“Percy”) Hooton
Authors: K Hooton
Journal: BMJ (2005)

Former consultant thoracic surgeon South East Thames region (b 1921; q King's College Hospital, London, 1944; FRCS), d 6 September 2004.​2004.




Figure 1




He was educated at Oundle School and Sidney Sussex College, Cambridge, before qualifying in medicine. He obtained his fellowship in 1949 and joined the Southern Regional Thoracic Unit at the Brook Hospital, London, as senior registrar in 1951. He became a consultant in 1955. He was well read and knowledgeable on many subjects, but his main passion was gardening. He leaves a wife, Kate; two sons; and five grandchildren.
The Rate of Death due to Injuries
Authors: Theodore C. Doege
Journal: JAMA (1991)

<h3>To the Editor.—</h3> Reviewing trends in death rates over recent decades, as did a recent article by Sutherland et al,<sup>1</sup>provides essential information that can help physicians focus on major causes of morbidity and guide the allocation of resources for prevention and research. The article by Sutherland and coworkers, I believe, understates the current impact of injuries. Injuries are not "the fourth leading cause of death," but the<i>third</i>leading cause. The authors' data in Fig 3 (p 3180) indicate that the death rate from injuries is higher than that from cerebrovascular disease, which they state is the "third leading cause of death." According to final age-adjusted mortality data for 1986 from the National Center for Health Statistics, the following were the four highest death rates per 100 000 persons in the United States: heart disease, 175.4; cancer, 132.5; unintended injuries, 35.5; and cerebrovascular disease, 30.4.<sup>2</sup> Unintended injuries,
Nitrofurantoin-Induced Chronic Active Hepatitis
Authors: MARTIN BLACK, LIONEL RABIN, NATHAN SCHATZ
Journal: Annals of Internal Medicine (1980)

Two patients developed a syndrome closely simulating the 'lupoid' form of chronic active hepatitis during prolonged therapy with macrocrystalline nitrofurantoin. Symptoms and biochemical indices of hepatocellular necrosis abated rapidly after discontinuation of drug therapy, but smooth muscle and antinuclear antibodies remained detectable more than 1 year later. The serologic features of the disease and a strongly positive lymphocyte transformation test in one of the patients suggest that the disorder may have been immunologically mediated.
A general practice experiment: technical aid to developing Africa.
Authors: N. Acheson, J. Stevens, I. Tait
Journal: BMJ (1965)

For some years various medical schools and hospitals in the United Kingdom have assisted with advice, sponsorship, and secondment of personnel to selected medical centres abroad. These arrangements have produced valuable results, but they leave untouched the problem of the great shortage of general duty medical officers. In areas where doctors are very scarce the majority of them must be prepared to act to the limit of their capacity in all branches of medicine. It is in this field that university and hospital secondments are of little use, since the future specialist cannot afford to undertake work that has little relevance to his future career. About three years ago it occurred to us that it might be possible to leave an English general practice and go in turn to Africa to take up posts as general-duty medical officers. The idea grew suddenly from fantasy to reality when a friend, just returned from Basutoland, agreed to act as a locum. The metamorphosis was not nearly as difficult as we had feared. This article gives an account of our experiences. It is presented in the hope that it may provoke other practices or individuals to go themselves. The need for them to do so is very great. Our practice in England is a rural one, with three partners,
The problem of insoluble fibre in irritable bowel syndrome
Authors: P. J Whorwell
Journal: BMJ (2009)

I was surprised to read in the popular press that, according to the BMJ ,1 fibre is good for irritable bowel syndrome.

In 1994 we suggested that, at least in secondary care, cereal fibre was more likely to do harm than good in patients with irritable bowel syndrome.2 Now, as a gastroenterologist probably seeing more cases of severe irritable bowel than most of my colleagues, I find that the total exclusion of all …
Artifacts in Portable ECG Monitoring
Authors: JAVAD MALEK
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 December 1972Artifacts in Portable ECG MonitoringJAVAD MALEK, M.D., ARTHUR GLUSHIEN, M.D.JAVAD MALEK, M.D.Search for more papers by this author, ARTHUR GLUSHIEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-6-1004_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Continuous electrocardiographic monitoring of the heart with a portable magnetic tape recorder was developed by Holter in 1957 (1). This device has been widely used for detection of transient arrhythmias and conduction disturbances during monitoring through 10 or more hours while the patient engages in his usual activity. Some advantages and limitations of the Holter Avionics instrument have been pointed out by Hinkle (2).Recently a tracing obtained with the Holter Avionics recorder seemingly showed supraventricular tachycardia at a rate of 300 per minute in a 50-year-old-man (Figure 1, Strip A). The patient did not complain of...References1. HOLTER N: Radioelectrocardiography : new technique for cardiovascular studies. Ann NY Acad Sci 65:913-923, 1957 CrossrefMedlineGoogle Scholar2. HINKLE L: Tape recordings of the ECG's of active men. Limitations and advantages of the Holter Avionics instruments. Circulation 36:752-765, 1967 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAVAD MALEK, M.D.; ARTHUR GLUSHIEN, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNicht-invasive Verfahren einschließlich Holter-MonitoringEvaluation of technician audiovisual scanning of ambulatory electrocardiograph recordings utilizing the rapid oscillographic printout technique of validationCar Wash TachycardiaC. RICHARD SMITH JR., D.O., DAVID ELBAUM, D.O.Unusual artifacts in electrocardiographic monitoringPractical advantages of two-channel electrocardiographic Holter recordingsArtifacts in portable electrocardiographic monitoringAmbulatory Electrocardiography for Diagnosis and Treatment of Cardiac ArrhythmiasFrequency domain characterization of artifact and tachyarrhythmias in the surface electrocardiogramInterference And Motion Artifact In Biopotentials 1 December 1972Volume 77, Issue 6 Page: 1004-1004 Keywords Arrhythmia Electrocardiography Electrode recording Heart Tachycardia ePublished: 1 December 2008 Issue Published: 1 December 1972 PDF downloadLoading ...
Barrett’s Esophagus: a Discrepancy between Macroscopic and Histological Diagnosis
Authors: E. Endlicher, P. Rümmele, S. Beer, R. Knüchel, H. Rath, K. Schlottmann, J. Grossmann, U. Woenckhaus, J. Schölmerich, H. Messmann
Journal: Endoscopy (2005)

The diagnosis of Barrett's esophagus at present requires endoscopic and histological confirmation of specialized intestinal metaplasia. This study prospectively analyzed the endoscopic and histological prevalence of Barrett's esophagus and the risk factors for the presence of Barrett's esophagus among patients being treated in an endoscopy unit.A total of 474 unselected patients (58% men; mean age 52 y) were included in the study. Two biopsy specimens each were taken from below and above the squamocolumnar junction and from the antrum and gastric body. Four-quadrant biopsies were taken every 1-2 cm to confirm a macroscopic suspicion of Barrett's esophagus.Barrett's esophagus was suspected at endoscopy in 109 patients (23%). Of the 109 patients with endoscopically suspected Barrett's esophagus, only 46 (42%) had the finding confirmed histologically. The sensitivity and specificity for the endoscopic diagnosis of Barrett's esophagus were 62% and 84%, respectively. A multivariate logistic regression analysis identified age (P = 0.0001; odds ratio per life-year 1.087; 95% CI, 1.046-1.139), male sex (P = 0.0020; OR 6.346; 95% CI, 2.094-22.314), and the number of biopsies (P = 0.0025; OR 1.661; 95% CI, 1.247-2.392) as factors associated with evidence of intestinal metaplasia on biopsy.The striking discrepancy between the endoscopic findings and the histological diagnosis may be due to the focal distribution of intestinal metaplasia. This emphasizes the importance of an adequate biopsy protocol. In addition, better methods of detecting focal islands of intestinal metaplasia that are not visible at conventional endoscopy are needed.
Whistleblower thanked but still suspended
Authors: R. Dobson
Journal: BMJ (2001)

An investigation by the Audit Commission has supported several concerns expressed by a consultant surgeon about private practice at a hospital in south Wales.

The investigation found that the Prince Philip Hospital at Llanelli had lost out on income, that private patients were not correctly charged for prostheses, and that private outpatients were not always billed for x ray examinations and injections.

A confidential letter detailing the findings of the investigation from the head of the commission's antifraud unit, also said that, at the time, no one at the Prince Philip Hospital had been formally designated as a private patients officer. Nor had the hospital any system for monitoring the effects on the NHS of its decision in 1997 to set aside the rule that full time NHS consultants should not derive more than 10% …
Insulin Treatment Reverses the Insulin Resistance of Type II Diabetes Mellitus
Authors: J A Scarlett, R S Gray, J Griffin, J M Olefsky, O G Kolterman
Journal: Diabetes Care (1982)

Type II diabetic subjects are both insulin-deficient and insulin-resistant. Recent studies suggest that the insulin resistance is due to a combined receptor and postreceptor defect with the postreceptor defect being the predominant lesion. In the present study, we examined the effects of exogenous insulin therapy upon these defects in insulin action in six untreated type II diabetic subjects. Glycemic control and adipocyte insulin binding were measured and in vivo insulin dose-response curves for overall glucose disposal and suppression of hepatic glucose output were constructed before treatment. Following these initial studies, the diabetic subjects were treated with twice-daily injections of regular and NPH purified pork insulin for 14 days and the pretreatment studies repeated. Glycemic control was significantly improved by this treatment regimen. The mean fasting serum glucose level (±SE) fell from 287 ± 20 to 125 ± 13 mg/dl, the mean glycosylated hemoglobin level (± SE) decreased from 14.2 ± 1.1% to 8.3 ± 0.5%, and the mean 24-h urinary glucose excretion (±SE) declined from 65.6 ± 40.3 to 0.6 ± 0. 1 g/24 h. Adipocyte insulin binding did not change significantly during the treatment period. In contrast, the 14-day period of insulin treatment produced a 72% increase (P &amp;lt; 0.005) in the maximal rate of insulin-stimulated glucose disposal, 321 ± 32 mg/M2/min compared with 187 ± 32 mg/M2/min before treatment, indicating that the postreceptor defect in insulin action was significantly ameliorated by insulin treatment. The dose-response curve for insulin-mediated suppression of hepatic glucose output was rightshifted, consistent with the decrease in insulin binding, with no decrease in the maximal effect before treatment and not significantly changed following insulin treatment. In conclusion, the postreceptor defect in insulin-stimulated glucose disposal is largely ameliorated by exogenous insulin treatment, suggesting that this defect in insulin action is an acquired abnormality which is secondary to some aspect of the insulin-deficient state.
The Effect of Adding Exenatide to a Thiazolidinedione in Suboptimally Controlled Type 2 Diabetes
Authors: Bernard Zinman, Byron J. Hoogwerf, Santiago Durán García, Denái R. Milton, Joseph M. Giaconia, Dennis D. Kim, Michael E. Trautmann, Robert G. Brodows
Journal: Annals of Internal Medicine (2007)

Background: Exenatide therapy is effective in combination with metformin or sulfonylureas for treating type 2 diabetes. Thiazolidinediones (TZDs) also are commonly used, but the efficacy of exenatide with a TZD has not been reported. Objective: To compare the effects of exenatide versus placebo on glycemic control. Design: Placebo run-in, randomized, double-blind, placebo-controlled trial conducted from May 2004 to August 2005. Setting: 49 sites in Canada, Spain, and the United States. Patients: 233 (exenatide group, n = 121; placebo group, n = 112) patients with type 2 diabetes that was suboptimally controlled with TZD treatment (with or without metformin). Mean (±SE) baseline glycated hemoglobin A1c level was 7.9% ± 0.1%. Interventions: Subcutaneous abdominal injections of 10 µg of exenatide or placebo twice daily, added to a TZD (with or without metformin) for 16 weeks. Measurements: The primary outcome was change from baseline in hemoglobin A1c level. Other outcomes were fasting serum glucose level, body weight, self-monitored blood glucose level, and any adverse events. Results: Exenatide treatment reduced hemoglobin A1c level (mean difference, −0.98% [95% CI, −1.21% to −0.74%]), serum fasting glucose level (mean difference, −1.69 mmol/L [−30.5 mg/dL] [CI, −2.22 to −1.17 mmol/L {−40.0 to −21.1 mg/dL}]), and body weight (mean difference, −1.51 kg [CI, −2.15 to −0.88 kg]). Sixteen percent of patients in the exenatide group and 2% of patients in the placebo group discontinued treatment because of adverse events. In the exenatide group, 40% (n = 48) of patients experienced nausea (mostly mild [n = 21] or moderate [n = 19]), 13% experienced vomiting, and 11% experienced hypoglycemia. In the placebo group, 15% of patients experienced nausea, 1% experienced vomiting, and 7% experienced hypoglycemia. Limitations: Combinations with TZDs and sulfonylureas were not tested. Trial duration was relatively short. Only 71% and 86% of patients in the exenatide and placebo groups, respectively, completed the study. Conclusions: Exenatide therapy improved glycemic control, reduced body weight, and caused gastrointestinal symptoms more than placebo in patients with type 2 diabetes that was suboptimally controlled with TZD therapy. ClinicalTrials.gov registration number: NCT00099320.
Anogenital papillomavirus infection in children
Authors: J D Oriel
Journal: BMJ (1988)

<b>Background:</b> The use of a chaperone in the clinical setting is a much debated subject. There have been many guidelines and papers written on this topic, but always from the medical profession’s point of view. For the first time, this survey focuses on the opinion of the patient. <b>Methods:</b> 800 consecutive patients attending the urology outpatient clinic were asked to complete a questionnaire on basic patient demographics and their opinions on chaperones. <b>Results:</b> Of 709 patients who completed the questionnaires, 553 (78%) were male. Overall, 535 (75.5%) patients did not want a chaperone present. Only 66 (42%) females stated a preference for the presence of a chaperone. Of the 174 patients requesting a chaperone, 102 (59%) patients wished the role to be taken by a friend or family member. 90% of these patients attended with the appropriate person. <b>Conclusions:</b> Most patients do not want a chaperone present for intimate examinations. Most women do not wish to have a chaperone present. Of those who do wish to have a chaperone present, more than half want a family member or friend to fill the role. This would be against current guidelines. However, in a “patient-centred” service, these results should be taken into consideration.
Combined Tc-99m MDP and Tc-99m Labeled RBC Imaging in a Case of Maffucci’s Syndrome
Authors: Ozgur Karacalioglu, Bengul Gunalp, Seyfettin Ilgan, Nuri Arslan, M Ali Ozguven
Journal: Clinical Nuclear Medicine (2004)

Maffucci's syndrome is characterized by multiple enchondromas combined with hemangiomas and less commonly lymphangiomas. The extent of skeletal involvement is variable in this rare nonhereditary syndrome, but the most frequent sites of enchondromas are the metacarpals and the phalanges of the hands and less commonly the feet. The bony and soft tissue lesions are likely to be much more extensive on one side of the body than the other. The clinical problems are progressive shortening of the involved extremity, angular deformity, pathologic fracture, and malignant transformation of the skeletal lesions. Effects of the disease range from those requiring minor adjustments in activities of daily life to almost total incapacitation. We report a case of 20-year-old man with Maffucci's syndrome involving the right lower and upper distal extremities with a variety of vascular proliferations.
Effect of Blood Glucose Control on Increased Glomerular Filtration Rate and Kidney Size in Insulin-Dependent Diabetes
Authors: Martin J. Wiseman, Andrew J. Saunders, Harry Keen, Giancario Viberti
Journal: New England Journal of Medicine (1985)

To investigate the relation between blood glucose control on the one hand and an increased glomerular filtration rate and enlarged kidneys on the other, we studied 12 patients with insulin-dependent diabetes and an increased glomerular filtration rate for a year after they were randomly assigned either to continuous subcutaneous insulin infusion or to unchanged conventional therapy. Glycemie control, measured by mean plasma concentrations of glucose and glycosylated hemoglobin, was rapidly and significantly improved (P<0.001) in the pump group but did not change in the conventional-treatment group. In the pump group, the glomerular filtration rate fell significantly in the study period (P<0.001) and became normal in four of the six patients. It did not change in the conventional-treatment group. There was no change in kidney volume in either group. At the end of a year, a return to conventional insulin treatment in the pump group resulted in both metabolic deterioration and a significant rise in the mean glomerular filtration rate towaro1 base-line values. We conclude that in patients with established insulindependent diabetes, strict glycemie control normalizes the glomerular filtration rate, although the kidneys may remain enlarged. (N Engl J Med 1985; 312:617–21.)
Accreditation after Goldstein.
Authors: S. Brearley
Journal: BMJ (1992)

wishes.There is not much evidence that including local councillors achieves such objectives.7But leaving that aside, what is to happen if local and central priorities diverge or if the views of general practitioners and patients pull in different directions?In this respect the rhetoric of the document may encourage expectations that cannot be fulfilled.7The main impression given by Your Good Health is of a document that addresses important issues seriously.It is overemphatic about the pathologies of the internal market, just as it is overreticent about the potential pathologies of its own more bureaucratic approach.It builds much more on the developments of the past decade than it is prepared to acknowledge, particularly in its emphasis on developing standards of quality and on patients rights.It leaves a lot of questions unanswered, notably about the precise role of the proposed Quality Commission -which has an extraordinarily ambitious remit.Above all, it makes no specific financial commitment about the funding of the NHS.But in this respect it is surely being only realistic and honest.There is no point in making precise pledges if there can be no certainty about the ability to carry them out.Under any government the funding of the NHS depends on how the economy performs and on the administration's choice between competing priorities.If the past few months have shown anything it is surely the dangers of economic prediction.