tbuckley/cabot-search huggingface dataset:
Towards Enhancing the Utility of Beth Israel Hospital Psychosomatic Questionnaire
Authors: T.G. Sriram, L. Pratap, V. Shanmugham
Journal: Psychotherapy and Psychosomatics (1988)

This study was aimed to develop uniform methods of rating the Beth Israel Hospital Psychosomatic Questionnaire (BIQ) to enhance its reliability and to obtain normative data. Certain guidelines were evolved to rate the items based on responses to probe questions, and the questionnaire administered to a sample of 116 normal subjects. The instrument was found to have adequate internal consistency. Test-retest reliability and interrater reliability, which were tested on two separate samples, were also found to be adequate. Using the cutoff at mean + 1 SD, 9.5% of the subjects studied (6% males and 3.5% females) were identified as alexithymic. Certain limitations of the instrument and directions for future research have been pointed out.
Beyond the trauma registry
Authors: TJ Coats, F Lecky, M Woodford
Journal: Journal of the Royal Society of Medicine (2009)

There is currently rapid progress in regionalization of trauma care in the UK following recommendations from the RCS(Eng), NCEPOD and the ‘Darzi’ Report. This process will result in groups of hospitals cooperating together to provide comprehensive trauma care within a region. The policy framework within the Department of Health (DoH) is also changing. Trauma care has become a priority area, and the recent appointment of a National Clinical Director for Trauma Care will help to align DoH policy with clinical need. This change in the configuration of services for the severely injured means that the quality system for trauma care also has to change. In the past, trauma audit has been based on individual hospital provider units, with about half of UK hospitals opting into the Trauma Audit and Research Network (TARN) system. This system is directed to clinicians at hospital trust level, providing information about individual hospital performance in the form of quarterly reports and other analyses, which are then used as the basis for multidisciplinary trauma audit meetings. There is significant variation in the attention paid to the quality of trauma care among Hospital Trusts. Those with a greater interest in trauma care hold regular (usually quarterly) multidisciplinary trauma meetings where information provided by the TARN trauma audit system is reviewed and individual cases presented to highlight areas for improvement or areas of good practice. These meetings usually rotate between a series of themes (head, limb, abdominal, thoracic and spinal injury). In contrast many (probably most) hospitals do not have a multidisciplinary trauma audit system and, at best, undertake trauma audit within specific departments (usually the Emergency Department). The regionalization of trauma care means that trauma audit will have to change its focus from the individual hospital trust to the whole regional trauma system, and will have to consider other stakeholders such as patients, regional trauma system managers, purchasers and regulators. Each of these groups will have their own perspective – so fulfilling such diverse needs will be a challenge. We will have to move further away from the American concept of a ‘trauma registry’ towards a very practical focus on the information needs of the quality assurance process within the regionalized trauma systems. In the future the quality system will need to be based on the whole regional trauma system rather than simply looking at individual hospitals. Future patient pathways are likely to involve several different healthcare providers and outcomes are likely to be crucially dependent on performance at the interfaces (patient handovers and transfers of care). The future need for a trauma quality system will therefore be on three levels:
Unnecessary hospitalisation in a psychiatric rehabilitation unit.
Authors: P. H. Dick, I. K. Crombie, T. Durham, C. McFee, M. Primrose, S. Mitchell
Journal: BMJ (1992)

Recent Scottish studies have claimed that 38% of "new chronic" inpatients and 32% of "old long stay" patients did not require inpatient care.' 2 We looked at a third group-admissions to a rehabilitation unit-to identify ways to reduce inpatient stay and to estimate the potential savings in inpatient time that could be achieved.The unit cares predominantly for patients with acute psychosis transferred from admission wards and patients with chronic psychosis admitted directly from the community.3
Breast cancer mortality in Europe is still rising, despite better screening
Authors: Rory Watson
Journal: BMJ (2007)

The annual number of new diagnoses of cancer in Europe has risen by 300 000 since 2004, says a new study from the International Agency for Research on Cancer.

Peter Boyle, director of the Lyon based agency and one of the authors of the report, which was published online on 7 February in the Annals of Oncology (http://annonc.oxfordjournals.org, doi: 10.1093/annonc/mdl498), warns that despite better prevention and treatment Europe faces a big increase in the incidence of cancer, largely because of its ageing population.

“Urgent action is particularly vital now to take preventive action against cancer, especially in central and eastern Europe, with strong and effective measures …
SI Units for Clinical Laboratory Data
Authors: Donald S. Young
Journal: JAMA (1978)

The international System of Units (SI) has not yet been accepted by American physicians because of reluctance to convert to a new system and the corresponding need for relearning. The impetus to introduce the SI came from European laboratory scientists; the system was later accepted (not always enthusiastically) by physicians after the same objections now voiced by their US counterparts were overcome. Now that many American laboratory scientists are actively studying and assessing the benefits of SI, we may have begun the chain of events that will lead to general acceptance by physicians in the United States.
Prescribing for women patients is less likely to follow guidelines than prescribing for their male counterparts
Authors: B. Roehr
Journal: BMJ (2012)

Women with diabetes and cardiovascular disease are less likely than men to be prescribed treatment recommended by guidelines, and they are less likely to be adherent to what is prescribed, according to an analysis of a prescription database of 30 million adult US citizens.

The analysis was drawn from the 16 million women and 13.5 million men in the Medco Health Solutions prescription database of drugs filled for the calendar year 2010. It was presented as a poster at the Women’s Health annual conference in Washington, DC.

The study found that on average women are prescribed more drugs than …
The clinical record in British general practice.
Authors: I G Tait
Journal: BMJ (1977)

<h3>Background</h3> GUIDE-IT, the largest trial to date, published in August 2017, evaluating the effectiveness of natriuretic peptide (NP)-guided treatment of heart failure (HF), was stopped early for futility on a composite outcome. However, the reported effect sizes on individual outcomes of all-cause mortality and HF admissions are potentially clinically relevant. <h3>Objective</h3> This systematic review and meta-analysis aims to combine all available trial level evidence to determine if NP-guided treatment of HF reduces all-cause mortality and HF admissions in patients with HF. <h3>Study selection</h3> Eight databases, no language restrictions, up to November 2017 were searched for all randomised controlled trials comparing NP-guided treatment versus clinical assessment alone in adult patients with HF. No language restrictions were applied. Publications were independently double screened and extracted. Fixed-effect meta-analyses were conducted. <h3>Findings</h3> 89 papers were included, reporting 19 trials (4554 participants), average ages 62–80 years. Pooled risk ratio estimates for all-cause mortality (16 trials, 4063 participants) were 0.87, 95% CI 0.77 to 0.99 and 0.80, 95% CI 0.72 to 0.89 for HF admissions (11 trials, 2822 participants). Sensitivity analyses, restricted to low risk of bias, produced similar estimates, but were no longer statistically significant. <h3>Conclusions</h3> Considering all the evidence to date, the pooled effects suggest that NP-guided treatment is beneficial in reducing HF admissions and all-cause mortality. However, there is still insufficient high-quality evidence to make definitive recommendations on the use of NP-guided treatment in clinical practice. <h3>Trial registration number</h3> Systematic Review Cochrane Database Number: CD008966.
Passive Inhalation of Marijuana Smoke
Authors: Russel Falck
Journal: JAMA (1983)

<h3>To the Editor.—</h3> The letter on the sensitivity of the enzyme-multiplied immunoassay technique (EMIT) in detecting the presence of cannabinoids in the urine of persons who have passively inhaled marijuana smoke points to the need for further study of the issue (1983;249:475). The authors' research suggests that it is highly unlikely that a person could passively inhale enough marijuana smoke to have a positive test result by the EMIT cannabinoid assay. It has been reported elsewhere that passive inhalation of marijuana smoke by a marijuana-naive subject can result in the presence of substantial quantities of cannabinoids in urine.<sup>1</sup>In this study, the urinary concentration of cannabinoids in a passive smoker was reported to be as high as 260 ng/mL, well in excess of the cutoff for a positive EMIT result regardless of whether the calibration is 20 or 50 ng/mL. Many factors influence the concentration of cannabinoids in urine:
Adjustable Prosthesis for Pulmonary Artery Banding
Authors: RAMON A. SHANE, GARMAN O. KIMMELL, WILLIAM E. JAQUES, GILBERT S. CAMPBELL
Journal: Circulation (1967)

An adjustable, stainless-steel "ball and saddle" prosthesis has been devised for banding the main pulmonary artery in dogs. Comparisons were made between this prosthesis and circumferential cotton umbilical and Teflon tape banding in 20 dogs. The vessel lumen and pressure gradient across the banded area returned to normal after release of the ball and saddle band, but not after release of the circumferential tape bands. However, microscopic damage to the banded artery was noted in all dogs, with attenuation of the media being most evident in dogs with the steel ball and saddle prosthesis.
A Study of Ulcerative Colitis in New Zealand, Showing a Low Incidence in Maoris
Authors: R. D. Wigley, B. P. Maclaurin
Journal: BMJ (1962)

As no population study of non-specific ulcerative colitis has yet been completed, the incidence of this disease in the community is not known. Hospital in-patient records and national mortality statistics provide the only information available, but it is not usually possible to define the population from which hospital cases are drawn. Weiner and Lewis (1960) have summarized the published hospital data. Melrose's (1955) finding that colitis was more common in England than in Scotland has not been borne out by subsequent statistics. Jones (1956) noted a higher admission rate in the north eastern part of the United States than in the south, comparing the number of colitis patients admitted with the total number of admissions. Acheson (1959), studying the mortality of this disease in the United States, Canada, and England and Wales, found rather higher death rates in England and Wales than in the U.S.A. or Canada. The rate was higher in north-east and central U.S.A. than in the south. The urban rate was higher than the rural rate and there was a negative correlation with the distribution of dysentery. Acheson (1960), using the Veterans Administration Hospital statistics, was able to confirm Paulley's (1950) finding that colitis is more common in Jews. There is some evidence that colitis is less common in North-American negroes (Weiner and Lewis, 1960), but Acheson (1960) was unable to find convincing evidence of this from the Veterans Administration figures. The disease is said to be very rare in the North-American Indian (Bebchuk et al., 1961) and in negro children in the U.S.A. (Reinhart, 1961). The familial incidence of colitis has been variously reported from 1 to 17%, and there have been two reports of the disease affecting identical twins (Feder, 1938 ; Lyons and Postlethwait, 1948). Houghton and Naish (1958) described two families with three cases, and possibly four in one of them. They thought that this incidence was greater than could occur by chance, but McConnell (1960) thinks that the general incidence of colitis may have been underestimated. The present findings suggest that the incidence was overestimated. All the reported familial cases were blood relations, chiefly siblings, except for two married couples noted by Felsen and Wolarsky (1955) and another couple treated by J. B. W. Dunlop (1960, personal communication). As New Zealand is a relatively closed community with a state medical service and all hospital discharge diagnoses have been filed under the international code since 1949, it is felt that useful information might be gained from a study of this material. We are indebted to Messrs. R. J. Rose and F. H. Foster, of the medical statistics branch at the Department of Health, New Zealand, for providing the relevant data.
Treatment of resistant rheumatoid arthritis by intra-articular infliximab injections: a pilot study
Authors: S N Nikas
Journal: Annals of the Rheumatic Diseases (2003)

heumatoid arthritis (RA) is a chronic inflammatory disease which is characterised mainly by synovial inflammation and joint destruction, as well as extraarticular manifestations. 1 Cytokines have a central role in the pathogenesis of this synovial inflammation.Tumour necrosis factor a (TNFa) is one of the dominant cytokines.Many studies have shown that TNFa is present in biologically significant amounts in RA synovial tissue and fluids, and the amount seems to parallel the extent of inflammation and bone erosion. 2 3 Persistent inflamed monarthritis in patients with RA is difficult to treat.Usually it is treated with local patches, intraarticular injections of steroids, or even with chemical, radioactive, or surgical synovectomy. 4 The introduction of anti-TNFa treatments, especially the infusion of infliximab, 5 prompted us to investigate the effectiveness and safety of intra-articular injection of infliximab in patients with RA and resistant monarthritis.
Primary care: core values Contracting for general practice: another turn of the wheel of history
Authors: B. M Goss
Journal: BMJ (1998)

Series editor: Mike Pringle

British general practitioners often assert their pride at being “independent contractors,” without remembering the origin of the term. Dr Ransome, pictured on his rounds as visiting physician to the local cottage hospital (box), was one of my predecessors in practice, and his extract from Kelly's 1908 directory of trade and professional people reminds us how most of our medical forebears earned their living.1 Others of my 19th century medical ancestors are entered in such directories as Surgeon to Waveney Valley Branch of Great Eastern Railway (Dr Adams, 18752), Surgeon to the Dispensary for the Poor (Dr Garneys, 18283), and Surgeon to the Rational Sick and Burial Association (Dr Johnstone, 18904).

This collection of contracts included occupational and public health services, treatment and certification of subscribers to friendly societies, care of inpatients at cottage hospitals, and a very basic service to the indigent poor (whether inside workhouses or on “outdoor relief,” as the forerunner of social security payment was called).

Although these arrangements initially seem to be relics of a bygone age, the modern general practitioner immunises children and adults, sees patients at the surgery or in the home, visits residential homes, and has hospital practitioner contracts at a community hospital or in a district hospital specialist department—he or she has a spectrum of work that bears a remarkable resemblance to that of Dr Ransome and his Victorian colleagues.

As well as these contracts, these doctors would have undertaken private consulting practice. John Scott, a well to do local diarist, records that he consulted Dr Garneys about his feeble sister Charlotte3 and, on behalf of concerned local worthies, about the 1849 outbreak of cholera in the town5. On New Year's Eve 1828 Dr Garneys was even called on to …
No laughing matter
Authors: SC Gandevia, JE Butler, JL Taylor, A Anand, A Paintal
Journal: The Lancet (1999)

S Overeem and colleagues (Sept 4, p838)1 report a dramatic reduction in the size of the H-reflex during laughter and propose that this reduction underlies the sensation of weakness that occurs with laughter and that it may precipitate cataplexy. Forced expiration and coughing have similar reflex effects; thus the respiratory accompaniments of laughter rather than its emotional origin may cause this sensation.
ANEURISM OF THE THORACIC AORTA
Authors: J. Walsh
Journal: BMJ (1856)

Wis blue line on the gums, the whole muscular structure was wasted from the scapulse to the forearms, with a clammy coldes, and a general want of power (feeling remaining rrfect), and a total absence of spasm or contraction.The was colder than the right, and slightly arched on its dorsal aspect; the thumb was wasted, and arched towards the palm.tIt was clearly one of those cases in which, as I pointed out in my work on the Bath waters, an error in diagnosis might easily be made; and to make sure of my own, I tested the urine of my patient, and found sulphuret of lead with the hydrosulphuret of ammonia, a test well known for its extreme accuracy, and the facility with which it may be applied to suspected fluids.With my concur- tence, my patient transmitted, twelve days after leaving home, ten ounces of urine, and two bottles, each containing the same quantity of his usual drinking water, the one boiled, and the other fresh, to Mr. Herapath, whose report I subjoin ; " I have analysed the contents of the three bottles for- warded, and I have found lead in all three of them.In the water from the boiler, there is also a trace of iron.Lead is in such qiuantity in the two waters, that I have no doubt that they will produce symptoms of lead poisoning, perhaps in numbness, and stiffness of the extremities, or in ' ead colic', loss of appetite, constipation, atrophy, palsy, or para- lysis, in fact, it is difficult to say in which form its effects will appear.The trace in the urine is very slight."
Implementation of rules based computerised bedside prescribing and administration: intervention study
Authors: P G Nightingale
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Ojectives:</b> To implement and assess a rules based computerised prescribing system with the aim of improving the safety of prescriptions and the administration of drugs. <b>Design:</b> Analysis of performance of computerised system plus questionnaire survey of users. <b>Setting:</b> 64 bed renal unit in a teaching hospital. <b>Intervention:</b> Introduction of the system into routine clinical use. <b>Main outcome measures:</b> Number of attempted prescriptions cancelled by the system; proportion of warning messages overridden; users9 comparisons of the system with conventional procedures. <b>Results:</b> Between October 1998 and August 1999 the system cancelled 58 (0.07%) out of 87 789 prescriptions on the grounds of clinical safety. In addition, 427 (57%) attempted prescriptions generating high level warnings and 1257 (8%) generating low level warnings were not completed. In a user survey 82% (31/38) of doctors and nurses considered the system to be an improvement on conventional procedures. <b>Conclusions:</b> The system has contributed to safety and patient care. All prescriptions are complete and legible, and transcription errors have been eliminated. The system assists clinicians when they are writing a prescription by making available information on patients. The system supports clinical decision making and has been well received by doctors, nurses, and pharmacists.
A STUDY OF THE COINCIDENCE OF SYPHILITIC AND NON-SYPHILTIC AFFECTIONS OF THE SKIN.
Authors: J. NEVINS HYDE
Journal: JAMA (1883)

There are certain vulgar prejudices relative to the physical condition of the subject of syphilis, whose influence is not without effect in the minds of many physicians. The difficulty, indeed, which even the most expert must at times encounter, in determining the exact nature of certain definitely evolved skin symptoms in such cases, needs no comment. It is a difficulty only too readily evaded by establishing a diagnosis of syphilis, and there abandoning all further ætiological question. The popular and pseudoscientific reasoning upon this point, traverses the entire field of clinical medicine. It is sufficiently common to read that the reporter of this or that history, suspecting that there was “a syphilitic element in the case,” did thus and so. The idea is prevalent that a mischievous, anomalous, capricious or remarkable change of symptoms, is due to the influence of a single one operating coincidently with several disease-factors; and that
Bisphenol A Induces Gene Expression Changes and Proliferative Effects through GPER in Breast Cancer Cells and Cancer-Associated Fibroblasts
Authors: Marco Pupo, Assunta Pisano, Rosamaria Lappano, Maria Francesca Santolla, Ernestina Marianna De Francesco, Sergio Abonante, Camillo Rosano, Marcello Maggiolini
Journal: Environmental Health Perspectives (2012)

Bisphenol A (BPA) is the principal constituent of baby bottles, reusable water bottles, metal cans, and plastic food containers. BPA exerts estrogen-like activity by interacting with the classical estrogen receptors (ERα and ERβ) and through the G protein-coupled receptor (GPR30/GPER). In this regard, recent studies have shown that GPER was involved in the proliferative effects induced by BPA in both normal and tumor cells.We studied the transduction signaling pathways through which BPA influences cell proliferation and migration in human breast cancer cells and cancer-associated fibroblasts (CAFs).We used as a model system SKBR3 breast cancer cells and CAFs that lack the classical ERs. Specific pharmacological inhibitors and gene-silencing procedures were used to show that BPA induces the expression of the GPER target genes c-FOS, EGR-1, and CTGF through the GPER/EGFR/ERK transduction pathway in SKBR3 breast cancer cells and CAFs. Moreover, we observed that GPER is required for growth effects and migration stimulated by BPA in both cell types.Results indicate that GPER is involved in the biological action elicited by BPA in breast cancer cells and CAFs. Hence, GPER-mediated signaling should be included among the transduction mechanisms through which BPA may stimulate cancer progression.