tbuckley/cabot-search huggingface dataset:
Asepsis in general practice.
Authors: G. A. Ayliffe
Journal: BMJ (1965)

Aseptic techniques in hospitals have been changing over the past few years and the influence of these changes on techniques in general practice will be considered in this article. A report on sterilizing practices in six hospitals published by the Nuffield Provincial Hospitals Trust1 indicated many deficiencies in traditional sterilizing methods. Following this and other publications, many central sterile supply departments have become established in hospitals. These departments pack and sterilize syringes, dressings, and other equipment, and distribute as required to wards and operating theatres. The main advan tages of this system are that sterilizing processes are carried out in one central department and are safer and more easily controlled ; boiling of equipment in the wards is almost or entirely eliminated and there is a saving of nurses' time. Dis posable equipment has also become more readily available and where necessary can be obtained in pre-sterilized packs from commercial sources. Although the use of disposables is some times expensive when compared with similar non-disposable equipment, costs will probably become less with increased demands. It is impossible to prove that the establishment of central sterile supply departments and the increased use of disposables has reduced hospital cross-infection, although some reports suggest that a reduction has occurred. Although wound sepsis is not a major problem in general practice, it is obviously preferable to use efficiently sterilized materials and equipment for all aseptic techniques, whether in hospital or in a patient's home. A recent report by the Queen's Institute of District Nursing2 indicates that standards of asepsis in domiciliary practice could be improved by the adoption of these new methods.
Biological drug use: US perspectives on indications and monitoring
Authors: J J Cush
Journal: Annals of the Rheumatic Diseases (2005)

An estimated 20% of patients with rheumatoid arthritis (RA) receive tumour necrosis factor (TNF) inhibitor treatment. This paper presents the results of an online survey of US rheumatologists (1023 respondents) conducted in April 2005 on issues relating to use of TNF inhibitors in RA. The primary determinant of TNF inhibitor use among the participating rheumatologists was physician preference rather than patient preference or payor guidelines. Qualitative (rather than quantitative measures) assessments (physician overall assessment, symptom review, etc.) and laboratory measures were more frequently employed when assessing and treating patients with RA. Clinical assessments with hepatic enzymes and complete blood count as an additional safety tool were most commonly employed to monitor drug safety. Nearly all the rheumatologists (> or = 92%) felt that a partial purified derivative (PPD) test was indicated when using a TNF inhibitor, but were equally split with regard to those with a history of PPD positivity or BCG vaccination. The frequency of serious adverse events was estimated and included tuberculosis, systemic fungal infection, demyelinating disorders, cytopenia, drug induced lupus, lymphoma, and hepatic failure. Among 454 RA patients who became pregnant while receiving biological therapy there were 378 normal deliveries, 9 premature babies, 5 therapeutic abortions, and 25 miscarriages. It was concluded that a greater than expected number of US rheumatologists are familiar with biologicals and TNF inhibitor therapies, but uncertainties and educational gaps still exist regarding their use and monitoring.
Serum insulin-like growth factor-I level is independently associated with coronary artery disease progression in young male survivors of myocardial infarction: beneficial effects of bezafibrate treatment
Authors: Giacomo Ruotolo, Peter Båvenholm, Kerstin Brismar, Suad Eféndic, Carl-Göran Ericsson, Ulf de Faire, Jan Nilsson, Anders Hamsten
Journal: Journal of the American College of Cardiology (2000)
Alendronate or Alfacalcidol in Glucocorticoid-Induced Osteoporosis
Authors: Ron N.J. de Nijs, Johannes W.G. Jacobs, Willem F. Lems, Roland F.J. Laan, Ale Algra, Anne-Margriet Huisman, Erik Buskens, Chris E.D. de Laet, Ans C.M. Oostveen, Piet P.M.M. Geusens, George A.W. Bruyn, Ben A.C. Dijkmans, Johannes W.J. Bijlsma
Journal: New England Journal of Medicine (2006)

Treatment with glucocorticoids is associated with bone loss starting soon after therapy is initiated and an increased risk of fracture.We performed a randomized, double-placebo, double-blind clinical trial of 18 months' duration among patients with a rheumatic disease who were starting glucocorticoids at a daily dose that was equivalent to at least 7.5 mg of prednisone. A total of 201 patients were assigned to receive either alendronate (10 mg) and a placebo capsule of alfacalcidol daily or alfacalcidol (1 microg) and a placebo tablet of alendronate daily. The primary outcome was the change in bone mineral density of the lumbar spine in 18 months; the secondary outcome was the incidence of morphometric vertebral deformities.A total of 100 patients received alendronate, and 101 received alfacalcidol; 163 patients completed the study. The bone mineral density of the lumbar spine increased by 2.1 percent in the alendronate group (95 percent confidence interval, 1.1 to 3.1 percent) and decreased by 1.9 percent in the alfacalcidol group (95 percent confidence interval, -3.1 to -0.7 percent). At 18 months, the mean difference of change in bone mineral density between the two groups was 4.0 percent (95 percent confidence interval, 2.4 to 5.5 percent). Three patients in the alendronate group had a new vertebral deformity, as compared with eight patients in the alfacalcidol group (of whom three had symptomatic vertebral fractures) (hazard ratio, 0.4; 95 percent confidence interval, 0.1 to 1.4).During this 18-month trial in patients with rheumatic diseases, alendronate was more effective in the prevention of glucocorticoid-induced bone loss than was alfacalcidol. (ClinicalTrials.gov number, NCT00138983 [ClinicalTrials.gov].).
HOW SHALL WE CONTROL VARIOLA?
Authors: S. L. JEPSON
Journal: JAMA (1899)

A pebble in the streamlet scant Has changed the course of many a river. Vigorous sanitation applied at the right time and in the right way will always prevent an epidemic of smallpox. No acute infectious disease is so easily controlled, because: 1. It manifests itself externally and should rarely be mistaker for any other disease; 2, it is greatly dreaded, and hence people are as a rule careful to avoid it; 3, its germs are easily destroyed; 4, we have in vaccination an absolutely certain protection. The last statement may be disputed, but the exceptions are so very rare that I think better to ignore them. My experience as a sanitary officer has brought to light a very great amount of prejudice against vaccination. This is largely based on the densest ignorance, but not a small part of it is due to the many bad results of careless vaccination—results
Mesenchymal stem cell interaction with ultra-smooth nanostructured diamond for wear-resistant orthopaedic implants
Authors: William C. Clem, Shafiul Chowdhury, Shane A. Catledge, Jeffrey J. Weimer, Faheem M. Shaikh, Kristin M. Hennessy, Valery V. Konovalov, Michael R. Hill, Alfred Waterfeld, Susan L. Bellis, Yogesh K. Vohra
Journal: Biomaterials (2008)
THE USE OF MECHANICAL MEASURES IN THE TREATMENT OF OBSTINATE EDEMA
Authors: EDWARD F. BLAND
Journal: JAMA (1930)

The treatment of severe and refractory edema of the lower extremities has occupied the attention of physicians for many centuries. The celebrated Roman philosopher Celsus,<sup>1</sup>of the first century A. D., in a chapter on "De Hydropicis," called attention to the beneficial effects of a low fluid intake as well as to the increased elimination of fluid by excessive sweating; but in addition to these measures it is of considerable interest to find the following recommendation given by him for the treatment of dropsy: "Above all an incision ought to be made, of almost four fingerbreadths, on the inner side [of the leg], from which much fluid may drain for several days." Although even today this original recommendation of Celsus is occasionally resorted to, more appropriate measures are now available. Great progress has been made during the last fifty years in the direction of a better understanding of cardiac
Aldehyde Dehydrogenase Activity Identifies a Population of Human Skeletal Muscle Cells With High Myogenic Capacities
Authors: Karine Vauchez, Jean-Pierre Marolleau, Michel Schmid, Patricia Khattar, Alain Chapel, Cyril Catelain, Séverine Lecourt, Jérôme Larghéro, Marc Fiszman, Jean-Thomas Vilquin
Journal: Molecular Therapy (2009)

Aldehyde dehydrogenase 1A1 (ALDH) activity is one hallmark of human bone marrow (BM), umbilical cord blood (UCB), and peripheral blood (PB) primitive progenitors presenting high reconstitution capacities in vivo. In this study, we have identified ALDH(+) cells within human skeletal muscles, and have analyzed their phenotypical and functional characteristics. Immunohistofluorescence analysis of human muscle tissue sections revealed rare endomysial cells. Flow cytometry analysis using the fluorescent substrate of ALDH, Aldefluor, identified brightly stained (ALDH(br)) cells with low side scatter (SSC(lo)), in enzymatically dissociated muscle biopsies, thereafter abbreviated as SMALD(+) (for skeletal muscle ALDH(+)) cells. Phenotypical analysis discriminated two sub-populations according to CD34 expression: SMALD(+)/CD34(-) and SMALD(+)/CD34(+) cells. These sub-populations did not initially express endothelial (CD31), hematopoietic (CD45), and myogenic (CD56) markers. Upon sorting, however, whereas SMALD(+)/CD34(+) cells developed in vitro as a heterogeneous population of CD56(-) cells able to differentiate in adipoblasts, the SMALD(+)/CD34(-) fraction developed in vitro as a highly enriched population of CD56(+) myoblasts able to form myotubes. Moreover, only the SMALD(+)/CD34(-) population maintained a strong myogenic potential in vivo upon intramuscular transplantation. Our results suggest that ALDH activity is a novel marker for a population of new human skeletal muscle progenitors presenting a potential for cell biology and cell therapy.
Infection Due to Corynebacterium Species in Marrow Transplant Patients
Authors: WALTER E. STAMM
Journal: Annals of Internal Medicine (1979)

A Corynebacterium species consistently resistant to all antibiotic therapy except vancomycin caused bacteremia in 32 of 284 (11%) marrow transplant patients. Twenty-one patients had colonization or infection before bacteremia. Twenty-six of the 32 patients were males, and males older than 16 years were infected significantly more often than females over 16, or than all patients under 16. A case-control study showed that infected patients had greater exposure to antibiotics; more often had failure of engraftment and persistent granulocytopenia; were in laminar air-flow rooms less often; and had greater inhospital mortality. Cultural surveillance showed that 17 of 42 marrow transplant patients were colonized with Corynebacterium species. Likelihood of colonization appeared related to age, sex, and duration of hospitalization. Prevalence of colonization in other populations was 1% in nonhospitalized healthy adults and 13% in adults in a general hospital. Corynebacterium species infections occur primarily in adult males with granulocytopenia, mucocutaneous defects, and receiving intensive antibiotic therapy.
Prioritisation: the new growth of the NHS
Authors: B. McCloskey
Journal: BMJ (2001)

As medical students gathered around a patient's bed in the 1970s and 1980s we were under orders never to use the word “cancer.” We could say “new growth,” “neoplasm,” or, for the more linguistically ambitious, “mitotic lesion,” but not “cancer.” To say the word would frighten the patient unnecessarily. By extension, not to say the word would make everything all right. There was almost a sense that if we did not say the word the problem would go away.

> The public will quickly learn that prioritisation has the same effect as rationing 

> Discussing cancer openly and honestly was much more sensible and humane 

Now in the 21st century we have a parallel problem emerging. The NHS cannot say the word “rationing.” We can say “prioritisation,” we can talk of “difficult choices,” and the lexicographically ambitious can say “rational decision making.” But we must not say “rationing.” Are we succumbing to the same myth that if we do not say the word the …
Lymphangioma circumscriptum associated with paravesical cystic retroperitoneal lymphangioma
Authors: A. D. IRVINE, L. SWEENEY, J.R. CORBETT
Journal: British Journal of Dermatology (1996)

A boy with long-standing congenital cutaneous lymphangioma circumscriptum (LC), presented at the age of 6 years with an episode of painless haematuria, subsequently attributed to bladder wall involvement of a paravesical cystic retroperitoneal lymphangioma. Magnetic resonance imaging demonstrated this lymphangioma to be in communication with the cutaneous lesions. Deep lymphatic and visceral involvement is an extremely unusual occurrence in association with LC. This is the first report of an association between LC and cystic retroperitoneal lymphangioma. LC occasionally heralds a deeper, more clinically significant lymphangioma which may not become apparent until many years after the initial dermatological presentation. We report this case to raise awareness of this potential association and to demonstrate the usefulness of magnetic resonance imaging in the assessment of the deep component of cutaneous lymphangiomas.
The optimal HbA_1c cutpoint to screen for diabetes in the emergency department was 6.0%
Authors: Eddy S. Lang
Journal: Annals of Internal Medicine (2012)

Source Citation Silverman RA, Thakker U, Ellman T, et al. Hemoglobin A1c as a screen for previously undiagnosed prediabetes and diabetes in an acute-care setting. Diabetes Care. 2011;34:1908-12. 21775751
THE CEREBRAL NEURONS IN RELATION TO MEMORY AND ELECTRICITY.
Authors: JAMES GRANT
Journal: JAMA (1901)

Professor Heger,<sup>1</sup>of Brussels, gives an account of experiments made on animals to determine the conditions of the brain cells, during various conditions of rest and stimulation, and concludes that "an important property of the cerebral nerve cell is its variability in reaction as regards its cell body, its processes, and its epidendritic granules. Changes in all three portions may co-exist or occur separately under different conditions. the further significance of which is important, and demands investigation." The nervous system reduced to its initial stage may be represented by two elements, a nerve cell, and a conducting tube, and it is the association of these two elements, which constitutes nerve centers and nerves.<i>Punch</i>tritely remarked, "What is matter never mind, what is mind, that's the matter." Although no relation of identity or analogy subsists, between mind and matter, a close relationship may be shown to exist between mind
Dissecting Aneurysm of the Aorta
Authors: Ben T. Galbraith, Stafford L. Norman
Journal: New England Journal of Medicine (1954)

Dissecting aneurysms have been known for centuries, but they were little more than curiosities until Shennan1 created interest in the subject with his masterful review in 1934. In 1942 Sailer2 collected 500 cases from the literature, only 33 of which had been diagnosed during life. Numerous reports since that time have shown that the condition is seen once in about 380 autopsies3 4 5 and that an ante-mortem diagnosis is possible in more than half the cases.6 , 7 Despite great interest in the subject in various medical centers many practitioners are not familiar with this condition, probably because most of the literature on . . .
Information, consideration needed—Brandt
Authors: Charles Marwick
Journal: JAMA (1985)

A number of lessons can be learned from the way medicine and government responded to the emergence of the acquired immunodeficiency syndrome (AIDS) as a public health problem. Four years after the first AIDS cases were reported, the former assistant secretary for health, Edward N. Brandt, Jr, MD, PhD—now chancellor of the University of Maryland School of Medicine, Baltimore—has called on the medical and scientific community to take a close look at the history of the AIDS epidemic so far. "We must try to understand society's response to this epidemic," he told some 2,000 physicians, other medical scientists, and public health authorities attending the International Conference on AIDS in Atlanta. Brandt admitted that such a study will be difficult to accomplish "in the partisan atmosphere that currently exists." But he suggested that "perhaps we can become more concerned with the discovery of truth than the exposure of errors—real or perceived."
Relation of high-density lipoprotein cholesterol concentration to type of diabetes and its control.
Authors: A L Kennedy, T R Lappin, T D Lavery, D R Hadden, J A Weaver, D A Montgomery
Journal: BMJ (1978)

Serum cholesterol and high-density lipoprotein (HDL) cholesterol concentrations were measured in 192 diabetics (94 with juvenile-onset and 98 with maturity-onset diabetes) and 177 non-diabetic controls. Hb A1C, an index of blood sugar control, was also measured in the diabetics. Serum cholesterol concentrations were similar in all the diabetics and controls, but HDL cholesterol concentrations were lower in patients with maturity-onset diabetes than in those with juvenile-onset diabetes and controls. There was no correlation in diabetics between HDL cholesterol and Hb A1C. We conclude that HDL cholesterol concentrations are abnormally low in patients with maturity-onset diabetes but essentially normal in those with juvenile-onset diabetes. They are not related to diabetic control.
A case of familial thrombocytosis: Possible role of altered thrombopoietin production
Authors: Tohru Fujiwara, Hideo Harigae, Junichi Kameoka, Hisayuki Yokoyama, Shinichiro Takahashi, Yasuo Tomiya, Minami Yamada, Kenichi Ishizawa, Masue Imaizumi, Takeshi Sasaki
Journal: American Journal of Hematology (2004)

Abstract Familial thrombocytosis (FT) is an inherited disorder with clinical presentations similar to essential thrombocytosis (ET). In several pedigrees, overproduction of thrombopoietin (TPO) has been shown to be responsible for the disease. We report herein three cases of thrombocytosis in three successive generations. All cases had increased serum TPO levels. Sequence analysis of TPO gene and transmembrane domain of c‐MPL, known as the TPO receptor, revealed no mutations. Platelet c‐MPL expression was similar or slightly increased as compared to normal volunteers. These data suggest that altered regulation of the TPO gene might be involved in the pathogenesis of FT. Am. J. Hematol. 76:395–397, 2004. © 2004 Wiley‐Liss, Inc.
Infertility set in context
Authors: Alejandro Chavez-Badiola, Andrew J Drakeley
Journal: BMJ (2007)

suicide riskBipolarity is important during treatment with antidepressants Rubino et al have identified that most (if not all) of the excess risk of suicide in a group of patients treated with venlafaxine could be explained by a higher burden of risk factors for suicide.It may be true that this group of patients had more severe or "difficult to treat" unipolar depression, but it is also possible that bipolar features in this group may be responsible for the observed raised rates of suicidality.Perhaps because of limitations of space, the authors do not discuss this as a possibility, despite an adjusted relative risk of completed suicide of 4.94 (95% confidence interval 1.30 to 18.84) for "past history of bipolar disorder" (table 3). 1 Recent work shows that at least 50% of difficult to treat unipolar depressed patients may have an undetected bipolar disorder, 2 and it is now well documented that antidepressant monotherapy for bipolar depression runs a high risk of precipitating hypomanic or mixed affective states, 3 which have been strongly associated with self harm and completed suicide. 4 It is also the case that venlafaxine seems more likely than other antidepressants to precipitate a switch into hypomania or mania in bipolar depression. 5Furthermore, many of the variables reported by Rubino et al could be considered to point towards high levels of bipolarity in the venlafaxine treated group, including higher rates of a family history of psychiatric disorder, more frequent prescription of antipsychotics and mood stabilisers, a history of non-response to several different antidepressants, and more frequent lifetime depressive episodes.
The Role of Myc-Induced Protein Synthesis in Cancer
Authors: Davide Ruggero
Journal: Cancer Research (2009)

Abstract Deregulation in different steps of translational control is an emerging mechanism for cancer formation. One example of an oncogene with a direct role in control of translation is the Myc transcription factor. Myc directly increases protein synthesis rates by controlling the expression of multiple components of the protein synthetic machinery, including ribosomal proteins and initiation factors of translation, Pol III and rDNA. However, the contribution of Myc-dependent increases in protein synthesis toward the multistep process leading to cancer has remained unknown. Recent evidence strongly suggests that Myc oncogenic signaling may monopolize the translational machinery to elicit cooperative effects on cell growth, cell cycle progression, and genome instability as a mechanism for cancer initiation. Moreover, new genetic tools to restore aberrant increases in protein synthesis control are now available, which should enable the dissection of important mechanisms in cancer that rely on the translational machinery. [Cancer Res 2009;69(23):8839–43]
A Society for the Protection of Science and Learning
Authors: None Rutherford
Journal: BMJ (1936)

Endothelial activation is an important feature of many inflammatory diseases and has been implicated as the cause of vascular complications in disorders such as diabetes, atherosclerosis, and transplant rejection. One of the most potent activators of the endothelium is TNF, which can also be expressed by endothelial cells, causing a permanent, autocrine stimulatory signal. To establish a model of continuous endothelial activation and to elucidate the role of endothelial derived TNF in vivo, we generated transgenic mice expressing a noncleavable transmembrane form of TNF under the control of the endothelial-specific tie2 promoter. Adult tie2-transmembrane TNF-transgenic mice developed chronic inflammatory pathology in kidney and liver, characterized by perivascular infiltration of mononuclear cells into these organs. Along with the infiltrate, an up-regulation of the adhesion molecules ICAM-1 and VCAM-1, but not E-selectin, in the endothelium was observed. Despite predisposition to chronic inflammation these mice were protected from immune-mediated liver injury in a model of Con A-induced acute hepatitis. Although the blood levels of soluble TNF and IFN-γ were increased in transgenic animals after challenge with Con A, no damage of hepatocytes could be detected, as assessed by the lack of increase in plasma transaminase activities and the absence of TUNEL staining in the liver. We conclude that expression of transmembrane TNF in the endothelium causes continuous endothelial activation, leading to both proinflammatory and protective events.