tbuckley/cabot-search huggingface dataset:
747-4 Evaluation of Regurgitant Jets by Sound Intensity Using a Pulsatile Flow Model: Potential Contribution of Regurgitant Volume and Reynolds Number
Authors: Marieke J.H. Baars, Dymph K. Aaftink, Arnaldo Passafini, Antoinette Kenny, Takahiro Shiota, David J. Sahn
Journal: Journal of the American College of Cardiology (1995)
Coeliac disease in primary care: case finding study
Authors: H. Hin, G. Bird, P. Fisher, N. Mahy, D. Jewell
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objectives</b>: To provide evidence of underdiagnosis of coeliac disease and to describe the main presenting symptoms of coeliac disease in primary care. <b>Design</b>: Case finding in a primary care setting by testing for coeliac disease by using the endomysial antibody test. <b>Setting</b>: Nine surgeries in and around a market town in central England, serving a population of 70 000. <b>Participants</b>: First 1000 patients screened from October 1996 to October 1997. <b>Outcome measures</b>: Determination of endomysial antibody titre of patients fulfilling the study criteria, followed by small intestine biopsy of those with positive results. <b>Results</b>: The 30 patients (out of 1000 samples) with positive results on the endomysial antibody test all had histological confirmation on small intestine biopsy. The commonest mode of presentation (15/30) was anaemia of varying severity. Most patients (25/30) presented with non-gastrointestinal symptoms. Specificity of the endomysial antibody test was 30/30. <b>Conclusions</b>: Underdiagnosis and misdiagnosis of coeliac disease are common in general practice and often result in protracted and unnecessary morbidity. Serological screening in primary care will uncover a large proportion of patients with this condition and should be made widely available and publicised. Coeliac disease should be considered in patients who have anaemia or are tired all the time, especially when there is a family history of the disease.
American Medicine at the Crossroads: Signs from Canada
Authors: Arnold S. Relman
Journal: New England Journal of Medicine (1989)

IN their incisive analysis of the Canadian health care system in this issue of the Journal,1 Evans and his colleagues offer some illuminating observations on the position of the medical profession.In Canada, where government pays almost all the bills, doctors are paid according to fixed fees and are not allowed to charge patients more. In some provinces there have been bitter political contests between the government and the profession over these matters. Although compromises have usually been reached on levels of payment, government — supported by public opinion — has stood firm on the issue of "extra billing." . . .
Serum Hemagglutinating Antibodies in Penicillin Allergy
Authors: Paul P. VanArsdel
Journal: JAMA (1963)

PENICILLIN HAS become a valuable model for the study of allergic drug reactions, not only because of its widespread use but also because of the detailed chemical information on its reactivity and metabolism which has been available for almost two decades. 1 However, studies on the nature of the penicillin antigen only recently established the fact that certain products of penicillin are chemically more reactive than penicillin itself, and thus more likely to act in the body as sensitizing haptens. Specifically, the reaction of penicillenic acid with proteins to form an antigenic penicilloyl-protein complex has been substantially confirmed. 2,3   After Ley et al 4 reported that sera from certain patients treated with penicillin agglutinated human erythrocytes preincubated with that drug, a separate line of study was pursued by several investigators to determine whether an association with clinical penicillin allergy could be made. However, certain of the results and interpretations which
Notes on the Wounded of the Royal Spanish Army, Made during a Short Visit to the North of Spain
Authors: J. Fleming
Journal: BMJ (1876)

It is very probably a provision of Nature that our blood-vessels, nerves, and nearly all our hones, arc of a rounded form, a form which permits bullets or other missiles to glide off rather than penetrate.This partial immunity may also have been owing in some degree to the peculiar form and construction of the projectiles, which were, I under-
Teaching Process Psychotherapy
Authors: H. Kelman
Journal: Psychotherapy and Psychosomatics (1972)

The courses 'The Psychoanalytic Process' and 'The Relating Process in Psychoanalysis' were described as to their form and content. This material was used to demonstrate how learning was fostered through experiencing. Teaching occurred through focusing on process and relating in the patient presented, the pre-sentor, the group members and the instructors. Demonstrating the many aspects, levels and dimensions of process and relating in the system individual-therapist deepened and widened the experiencing of both. To identify and expand the what and how of process, the technique of open-ended feeling questions was used. The differences in the evolution in the group response in the two courses and in a group therapeutic situation were described and discussed.
PROBABLE PLACENTAL TRANSMISSION OF TUBERCULOSIS.
Authors: JOHN R. WILLIAMS
Journal: JAMA (1907)

recently recommended1 im- mediate percussion with a rubber tube, which, he be- lieves, is a "method of greater precision" and possessing "superior advantages over methods in common use."The usefulness of all methods of percussion depends, of course, largely on the individual who uses them; good as well as bad results can be obtained with almost any method.But a new clinical method must have both intrinsic as well as heuristic value, otherwise it consti- tutes merely an encumbrance to an already confusingly
Long-Term Survival and Repeat Coronary Revascularization in Dialysis Patients After Surgical and Percutaneous Coronary Revascularization With Drug-Eluting and Bare Metal Stents in the United States
Authors: Gautam R. Shroff, Craig A. Solid, Charles A. Herzog
Journal: Circulation (2013)

Few published data describe long-term survival of dialysis patients undergoing surgical versus percutaneous coronary revascularization in the era of drug-eluting stents (DES).Using United States Renal Data System data, we identified 23 033 dialysis patients who underwent coronary revascularization (6178 coronary artery bypass grafting, 5011 bare metal stents, 11 844 DES) from 2004 to 2009. Revascularization procedures decreased from 4347 in 2004 to 3344 in 2009. DES use decreased by 41% and bare metal stent use increased by 85% from 2006 to 2007. Long-term survival was estimated by the Kaplan-Meier method, and independent predictors of mortality were examined in a comorbidity-adjusted Cox model. In-hospital mortality for coronary artery bypass grafting patients was 8.2%; all-cause survival at 1, 2, and 5 years was 70%, 57%, and 28%, respectively. In-hospital mortality for DES patients was 2.7%; 1-, 2-, and 5-year survival was 71%, 53%, and 24%, respectively. Independent predictors of mortality were similar in both cohorts: age >65 years, white race, dialysis duration, peritoneal dialysis, and congestive heart failure, but not diabetes mellitus. Survival was significantly higher for coronary artery bypass grafting patients who received internal mammary grafts (hazard ratio, 0.83; P<0.0001). The probability of repeat revascularization accounting for the competing risk of death was 18% with bare metal stents, 19% with DES, and 6% with coronary artery bypass grafting at 1 year.Among dialysis patients undergoing coronary revascularization, in-hospital mortality was higher after coronary artery bypass grafting, but long-term survival was superior with internal mammary grafts. In-hospital mortality was lower for DES patients, but the probability of repeat revascularization was higher and comparable to that in patients receiving a bare metal stent. Revascularization decisions for dialysis patients should be individualized.
The multinational birth cohort of EuroPrevall: background, aims and methods
Authors: T. Keil, D. McBride, K. Grimshaw, B. Niggemann, P. Xepapadaki, K. Zannikos, S. T. Sigurdardottir, M. Clausen, M. Reche, C. Pascual, A. P. Stanczyk, M. L. Kowalski, R. Dubakiene, G. Drasutiene, G. Roberts, A.‐F. A. Schoemaker, A. B. Sprikkelman, A. Fiocchi, A. Martelli, S. Dufour, J. Hourihane, M. Kulig, M. Wjst, M. Yazdanbakhsh, Z. Szépfalusi, R. Van Ree, S. N. Willich, U. Wahn, E. N. C. Mills, K. Beyer
Journal: Allergy (2009)

To cite this article: Keil T, McBride D, Grimshaw K, Niggemann B, Xepapadaki P, Zannikos K, Sigurdardottir ST, Clausen M, Reche M, Pascual C, Stanczyk AP, Kowalski ML, Dubakiene R, Drasutiene G, Roberts G, Schoemaker A‐FA, Sprikkelman AB, Fiocchi A, Martelli A, Dufour S, Hourihane J, Kulig M, Wjst M, Yazdanbakhsh M, Szépfalusi Z, van Ree R, Willich SN, Wahn U, Mills ENC, Beyer K. The multinational birth cohort of EuroPrevall: background, aims and methods. Allergy 2010; 65 : 482–490. Abstract Background/aim: The true prevalence and risk factors of food allergies in children are not known because estimates were based predominantly on subjective assessments and skin or serum tests of allergic sensitization to food. The diagnostic gold standard, a double‐blind placebo‐controlled food provocation test, was not performed consistently to confirm suspected allergic reactions in previous population studies in children. This protocol describes the specific aims and diagnostic protocol of a birth cohort study examining prevalence patterns and influential factors of confirmed food allergies in European children from different regions. Methods: Within the collaborative translational research project EuroPrevall, we started a multi‐center birth cohort study, recruiting a total of over 12 000 newborns in nine countries across Europe in 2005–2009. In addition to three telephone interviews during the first 30 months, parents were asked to immediately inform the centers about possible allergic reactions to food at any time during the follow‐up period. Results: All children with suspected food allergy symptoms were clinically evaluated including double‐blind placebo‐controlled food challenge tests. We assessed sensitization to different food allergens by measurements of specific serum immunoglobulin E and skin prick tests, collect blood, saliva or buccal swabs for genetic tests, breast milk for measurement of food proteins/cytokines, and evaluate quality‐of‐life and economic burden of families with food allergic children. Conclusions: This birth cohort provides unique data on prevalence, risk factors, quality‐of‐life, and costs of food allergies in Europe, leading to the development of more informed and integrated preventative and treatment strategies for children with food allergies.
Experimental Withdrawal of Lithium in Recovered Manic-Depressive Patients: A Report of Five Cases
Authors: JOYCE G. SMALL, IVER F. SMALL, DONALD F. MOORE
Journal: American Journal of Psychiatry (1971)

The authors conducted a single-blind study to determine whether patients with manic-depressive disease who responded favorably to lithium would show significant change when placebo was substituted. Symptoms recurred in all subjects within six weeks of placebo substitution, and clinical stability returned when lithium treatment was resumed. These findings are discussed in relation to the question of the prophylactic influence of long-term maintenance on lithium.
Europe's opportunity to open up drug regulation
Authors: S. Garattini, V. Bertele'
Journal: BMJ (2010)

Among the priorities for the European health directorate, DG Sanco, as it takes control of the agency in charge of drug regulation should be to end the secrecy surrounding approval decisions, say <b>Silvio Garattini</b> and <b>Vittorio Bertele’</b>
Evidence for a lipid specific effect in nutrient induced human proximal gastric relaxation
Authors: J T McLaughlin, L E A Troncon, J Barlow, L J Heggie, D G Thompson
Journal: Gut (1998)

Background/Aim —The presence of lipid in the upper gut is able to modify gastrointestinal motor performance, but its influence on the relaxation of the human stomach, which is known to modify gastric emptying, remains incompletely understood. The relaxation of the proximal stomach in response to various lipid concentrations was therefore studied in healthy volunteers. Since the observed effects could be mediated through osmolality or energy sensitive pathways, the effects of equicaloric and equiosmolar non-lipid solutions were also determined. Methods —The tone of the proximal stomach was measured during stepwise inflation of a non-compliant bag sited in the proximal stomach, both before and after a test meal was delivered intragastrically. Iso-osmolar lipid emulsions were diluted in iso-osmolar saline at concentrations of 1.25, 2.5, 5, 10, and 20%. NaCl solutions at osmolalities of 300, 600, 1200 and 2400 mmol/kg and glucose solutions of 836 and 3344 kJ/l were also given. Results —All lipid meals of 2.5% or greater concentration induced a reduction in gastric tone in a non-dose-dependent manner, responses to 5% lipid (median (range) 74 (62–92)%) being similar to those to 20% lipid (80 (55–83)%; p&gt;0.05). No relaxation was elicited by isocaloric glucose. NaCl only consistently caused relaxation at 2400 mmol/kg. Conclusion —Lipid meals reduce human proximal gastric tone by a lipid specific mechanism, independently of their energy content or osmolality.
METHYLANDROSTENEDIOL IN PALLIATIVE TREATMENT OF BREAST CANCER
Authors: S. C. Kasdon
Journal: JAMA (1952)

In a preliminary publication<sup>1</sup>the need was emphasized for further critical evaluation of methylandrostenediol (17α methyl Δ<sup>5</sup>androstene 3β, 17β-diol) as a potentially useful palliative agent in recurrent or inoperable mammary carcinoma. Results in 44 cases, 7 of which were previously reported, are described. <h3>PLAN OF STUDY</h3> The patients studied, modes of administration and total dosage of steroid, and length of treatment are summarized in table 1. The dosage schedule was 25 mg. of methylandrostenediol six times per week for patients receiving oil suspensions, 100 mg. three times per week for those ambulatory patients receiving aqueous suspensions, and 100 mg. seven times per week for hospitalized patients. Pellets (150 to 300 mg.) were given at one, two, and four-week intervals. Oral medication was given in 100, 150, 200, and 300 mg. daily doses. Twenty of the patients were ambulatory and were seen at weekly intervals excepting those
Left Ventricular Size after Acute Myocardial Infarction
Authors: WILLIAM J. KOSTUK, THOMAS M. KAZAMIAS, MARTIN P. GANDER, ALLAN L. SIMON, JOHN ROSS
Journal: Circulation (1973)

The distance from the midline to the left heart border measured in a standardized manner on calibrated chest roentgenograms was determined serially in 125 patients after acute myocardial infarction. This external left heart dimension (LHD) was compared to the normal value, and its prognostic value was assessed during early and late follow-up periods (average 10½, range 2-31 months). Within 96 hours after acute myocardial infarction the initial LHD was enlarged (&gt;52 mm/m 2 BSA [body surface area]) in 42% of the patients. The LHD became normal, or remained persistently normal in 60% of the 115 patients without shock, and it became enlarged or remained persistently enlarged in 40%. If the 10 patients with cardiogenic shock are excluded, early death (&lt;4 weeks) occurred in three of 68 patients (4%) with initially normal LHD, and in 12 of 47 patients (26%) with initially enlarged LHD ( P &lt; 0.001). The LHD remained normal or became normal in 62 of 96 patients followed who survived more than 1 month. During the follow-up period, 8% of patients with a normal LHD have died and the remainder (with one exception) are in New York Heart Association (NYHA) class I or II. Only 5% of this group died of acute cardiac causes. In 34 patients the LHD became or remained persistently enlarged; of these patients 24% have expired ( P &lt; 0.05) and 42% are in NYHA class III ( P &lt; 0.001). This study validates a method for the early detection and serial assessment of left ventricular enlargement and indicates that the LHD is a useful predictor of survival and morbidity after acute myocardial infarction.
Prevalence and Correlates of Shoplifting in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
Authors: Carlos Blanco, Jon Grant, Nancy M. Petry, H. Blair Simpson, Analucia Alegria, Shang-Min Liu, Deborah Hasin
Journal: American Journal of Psychiatry (2008)

This study presented nationally representative data on the lifetime prevalence, correlates, and comorbidity of shoplifting among adults in the United States.Data were derived from a large national sample of the United States population. Face-to-face surveys of more than 43,000 adults ages 18 years and older residing in households were conducted during the 2001-2002 period. Diagnoses of mood, anxiety, and drug disorders as well as personality disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version.The prevalence of lifetime shoplifting in the U.S. population was 11.3%. Associations between shoplifting and all antisocial behaviors were positive and significant. Besides stealing, the behaviors more strongly associated with shoplifting were making money illegally and scamming someone for money. Strong associations between shoplifting and all 12-month and lifetime comorbid psychiatric disorders were also found. The strongest associations with shoplifting were with disorders often associated with deficits in impulse control, such as antisocial personality disorder, substance use disorders, pathological gambling, and bipolar disorder. High rates of mental health service use were also identified in this population.Shoplifting is a relatively common behavior. A history of shoplifting is associated with substantial rates of comorbid disorders, psychosocial impairment, and mental health service use. Future research should identify the biological and environmental underpinnings of shoplifting and develop effective screening tools and interventions for individuals with shoplifting problems.
Intestinal Necrosis as a Complication of Epinephrine Injection Therapy During Double-Balloon Enteroscopy
Authors: H.-H. Yen, Y.-Y. Chen, W.-W. Su, M.-S. Soon, Y.-M. Lin
Journal: Endoscopy (2006)

A 77-year-old woman was admitted because she had been passing tarry stools for 1 week. She had a past medical history of hypertension, coronary artery disease, and uremia requiring dialysis. Following negative upper endoscopy and colonoscopy examinations, she underwent double-balloon enteroscopy. Several blood clots were found in the jejunum and a source of active bleeding was found after 2 hours' examination (Figure [1]). Injection therapy with a total of 3 ml of 1 in 10 000 epinephrine in hypertonic saline resulted in initial hemostasis, but the bleeding recurred 2 days later. The patient required surgical intervention, when segmental ecchymosis of the intestine was observed, 280 cm from the ileocecal valve (Figure [2]). The remaining small intestine was unremarkable. Subsequent histological examination revealed ischemic necrosis, involving only 1.5 cm of the resected intestine, which we believed corresponded with the injection site. The patient experienced no further bleeding over a 6-month period after the operation.
Plaque Characteristics in Culprit Lesions and Inflammatory Status in Diabetic Acute Coronary Syndrome Patients
Authors: Young Joon Hong, Myung Ho Jeong, Yun Ha Choi, Jum Suk Ko, Min Goo Lee, Won Yu Kang, Shin Eun Lee, Soo Hyun Kim, Keun Ho Park, Doo Sun Sim, Nam Sik Yoon, Hyun Ju Yoon, Kye Hun Kim, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Journal: JACC. Cardiovascular imaging (2009)
Restriction endonuclease analysis of DNA from two isolates of Chlamydia psittaci obtained from human abortions.
Authors: A J Herring, I E Anderson, M McClenaghan, N F Inglis, H Williams, B A Matheson, C P West, M Rodger, P P Brettle
Journal: BMJ (1987)

Restriction endonuclease analysis of DNA from two isolates of Chlamydia psittaci obtained from human abortions Together, clinical, epidemiological, and serological studies have provided considerable evidence that Chlamydia psinaci of ovine origin may infect and cause abortion in pregnant women.'In 1985 the first recovery of C psittaci from placental and fetal tissues was reported.The isolate was shown to have serological and cultural properties similar to ovine abortion strains2 but could not unequivocally be shown to be of ovine origin. Patients, methods, and resultsCase I-The circumstances surrounding the patient's abortion have been reported.2A chlamydial cell culture of the original isolate in McCoy cells was
Changing perspectives of general medicine on general practice
Authors: G. I Varughese
Journal: Journal of the Royal Society of Medicine (2006)

The contribution of general practice to NHS patients cannot be commended more.1 The aspirations and visions for the future of general practice are splendid.2 However, as general medical registrars, we have started to experience the changes to the variety of referrals as well as number of admissions to the medical admissions unit (MAU). Hospital admissions may have fallen sharply and no doubt general practitioners are under pressure.3 On the other hand, in real life, working in the MAU has changed dramatically, with an increasing number of acute referrals. The expectations from patients, pressures of family members, and perhaps the fear of litigation may be compounding factors. Nevertheless, this adds to the queues of trolleys waiting outside MAU, adding to the work-load of the already busy medical team with patients to look after not only in general medical wards, but also in outlier surgical wards.

We are only trying to call attention to the changing culture over the years. This trend has obviously had an impact on the dynamic young medics deciding on careers involving specialties sans general medicine. Indeed, general medicine has also slipped down the priority list in favour of specialist interests, despite remaining in the front line.4 The need for a concerted approach and greater interaction between primary and secondary care is warranted with active investment in both sectors.