tbuckley/cabot-search huggingface dataset:
Early intervention in acute renal failure: Assessing fluid status is important
Authors: Jonathan M Gleadle
Journal: BMJ (2006)

Evidence based diagnosis We may need to be open to new ideasEditor-If evidence based diagnosis is still in the dark ages, as Delamothe writes, 1 then so is evidence based treatment.The doctor's job is to choose the right treatment.If the diagnosis is wrong then the treatment will be wrong.Inaccurate diagnoses will also affect clinical trials.A treatment may be "evidence based" because it has worked in a published study, but some patients who would have responded might have been left out because of diagnostic inaccuracy while some patients with no prospect of responding might have been included incorrectly. 2vidence based diagnosis is about convincing others using shared rules of evidence that a diagnosis (and its implications in terms of treatment) should be accepted by others.Evidence is gathered from the individual and from groups of patients. 3Evidence based diagnosis means specifying the individual's facts in addition to pointing to facts relating to that diagnosis in the literature. 4ayes's theorem uses unconditional initial prior probabilities.Diagnostic leads are based on conditional probabilities and are used to initiate diagnostic thought processes. 4owever, closely related theorems can be used to interpret diagnostic leads, which allow doctors to reason with diagnostic evidence in a more familiar way, 3 thus reducing misunderstandings. 5So to improve evidence based diagnosis we also need to collect better data on diagnostic leads.The published evidence given for a diagnosis and any related actions cannot realistically be assembled when actually seeing a patient.A draft evidence based rationale might be prepared in advance.It would have to be capable of being accessed in seconds to provide evidence in support of a suspected diagnosis and decision arrived at by using kindness, imagination, and common sense.It could be put into context by inserting the patient's details into the draft evidence summoned up from a computer.If we are to make progress and allow evidence based diagnosis to emerge from the dark ages then in addition to doing more of the same, we may also have to be receptive to new ideas.
Children in Turkey die after contracting avian flu
Authors: Jane Parry
Journal: BMJ (2006)

The World Health Organization has sent a team of experts to eastern Turkey to investigate the outbreak of H5N1 avian flu there, after three children in the area died from the infection.

The confirmed cases have been attributed to close contact with infected poultry, but much remains unknown about the situation in Turkey, said Maria Cheng, a WHO spokeswoman in Geneva. “We have too little information. We don't know if it's the same strain of the virus that is circulating in Asia,” she said.

The Turkish authorities reported to WHO …
Hematopoietic stem cell–engrafted NOD/SCID/IL2Rγnull mice develop human lymphoid systems and induce long-lasting HIV-1 infection with specific humoral immune responses
Authors: Satoru Watanabe, Kazuo Terashima, Shinrai Ohta, Shigeo Horibata, Misako Yajima, Yoko Shiozawa, M. Zahidunnabi Dewan, Zhong Yu, Mamoru Ito, Tomohiro Morio, Norio Shimizu, Mitsuo Honda, Naoki Yamamoto
Journal: Blood (2006)
Spectrum and Frequency of Cardiac Channel Defects in Swimming-Triggered Arrhythmia Syndromes
Authors: Grace Choi, Laura J. Kopplin, David J. Tester, Melissa L. Will, Carla M. Haglund, Michael J. Ackerman
Journal: Circulation (2004)

Background— Swimming is a relatively genotype-specific arrhythmogenic trigger for type 1 long-QT syndrome (LQT1). We hypothesize that mimickers of concealed LQT1, namely catecholaminergic polymorphic ventricular tachycardia (CPVT), may also underlie swimming-triggered cardiac events. Methods and Results— Between August 1997 and May 2003, 388 consecutive, unrelated patients were referred specifically for LQTS genetic testing. The presence of a personal and/or family history of a near-drowning or drowning was determined by review of the medical records and/or phone interviews and was blinded to genetic test results. Comprehensive mutational analysis of the 5 LQTS-causing channel genes, KCNQ1 (LQT1), KCNH2 (LQT2), SCN5A (LQT3), KCNE1 (LQT5), and KCNE2 (LQT6), along with KCNJ2 (Andersen-Tawil syndrome) and targeted analysis of 18 CPVT1-associated exons in RyR2 , was performed with the use of denaturing high-performance liquid chromatography and direct DNA sequencing. Approximately 11% (43 of 388) of the index cases had a positive swimming phenotype. Thirty-three of these 43 index cases had a “Schwartz” score (≥4) suggesting high clinical probability of LQTS. Among this subset, 28 patients (85%) were LQT1, 2 patients (6%) were LQT2, and 3 were genotype negative. Among the 10 cases with low clinical probability for LQTS, 9 had novel, putative CPVT1-causing RyR2 mutations. Conclusions— In contrast to previous studies that suggested universal LQT1 specificity, genetic heterogeneity underlies channelopathies that are suspected chiefly because of a near-drowning or drowning. CPVT1 and strategic genotyping of RyR2 should be considered when LQT1 is excluded in the pathogenesis of a swimming-triggered arrhythmia syndrome.
The Effect of Strict Control with the Artificial β-Cell on Plasma Lipid Levels in Insulin-Dependent Diabetes
Authors: Fredericka V Vlachokosta, A Cader Asmal, Om P Ganda, Thomas T Aoki
Journal: Diabetes Care (1983)

The artificial β-cell can establish normoglycemia within 2 h in an indifferently controlled diabetic patient. In the present study, the temporal relationship between the achievement of normoglycemia and its effect on plasma lipid concentrations has been examined in 12 insulin-dependent diabetic patients regulated by the artificial β-cell for 7 days. The fasting values (mean ± SEM) of blood glucose (BG), triglycerides (TG), total cholesterol (T-chol), HDL-cholesterol (HDL), and the calculated LDL/HDL ratio (obtained while participants were on single or split insulin regimens) were 385 ± 42 mg/dl, 148 ± 24 mg/dl, 219 ± 22 mg/dl, 39 ± 3.6 mg/dl, and 3.8 ± 1.04, respectively. Within 12 h of establishing normoglycemia TG levels fell to 87 ± 10 mg/dl (P &amp;lt; 0.001), T-chol to 196 ± 15 mg/dl (P &amp;lt; 0.005), and HDL to 37 ± 3 mg/dl (P = NS). The LDL/HDL ratio remained unchanged. After 7 days on the artificial β-cell, the corresponding values were: 73 ± 5 mg/dl (P &amp;lt; 0.001), 169 ± 9 mg/dl (P &amp;lt; 0.001), 41 ± 2.6 mg/dl (P = NS), and 2.6 ± 0.56 (P &amp;lt; 0.05). Twenty-four hours after discontinuation of artificial β-cell therapy, the TG and T-chol concentrations reverted to baseline. These findings underscore the rapidity and effectiveness with which strict control can improve plasma lipid profiles.
Providing primary care in the accident and emergency department
Authors: I R S Robertson-Steel
Journal: BMJ (1998)

Out of hours calls to general practitioners have doubled in the last three years,1 while emergency admissions to hospitals have increased by 16% from 1988–9 to 1993-4, with some hospitals seeing a doubling since 1993.2 3 Yet accident and emergency departments—a major gateway to the hospital—treat a mixed group of patients, and only a small proportion of the 15 million people who visit Britain's 227 accident and emergency departments each year4 are critically ill or injured. What drives the increasing demands on accident and emergency services and out of hours calls to general practitioners is not yet understood, but attempts are being made to manage the workload in a way more appropriate to the problems it presents.

Until recently the accident and emergency community blamed many of its problems on “inappropriate attenders.” That attitude is changing, with the recognition that many attenders need primary care. Lack of an agreed British national triage system makes valid comparisons difficult, but the British Association of Accident …
Congenital linear porokeratotic eccrine ostial dermal duct naevus
Authors: L.A. Murphy, D.J. Atherton
Journal: British Journal of Dermatology (2003)

Journal Article Congenital linear porokeratotic eccrine ostial dermal duct naevus Get access L.A. Murphy, L.A. Murphy Paediatric Dermatology, St Johns Institute of Dermatology, London Search for other works by this author on: Oxford Academic Google Scholar D.J. Atherton D.J. Atherton Paediatric Dermatology, St Johns Institute of Dermatology, London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 148, Issue 6, 1 June 2003, Page 1293, https://doi.org/10.1046/j.1365-2133.2003.05524_8.x Published: 01 June 2003
Hypertension and Hypogenitalism: Two New Varieties of This Clinical Association.
Authors: Otto Kuchel
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970Hypertension and Hypogenitalism: Two New Varieties of This Clinical Association.Otto Kuchel, M.D., Pavel Hamet, M.D., Wojciech Nowaczynski, D.SC., Marcel Cadotte, M.D., Jacques Genest, M.D., F.A.C.P.Otto Kuchel, M.D.Search for more papers by this author, Pavel Hamet, M.D.Search for more papers by this author, Wojciech Nowaczynski, D.SC.Search for more papers by this author, Marcel Cadotte, M.D.Search for more papers by this author, Jacques Genest, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-788_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFifteen to 25% of patients with gonadal dysgenesis have "essential" hypertension. The deficiency of 17-hydroxylation is another rare form of hypertension associated with hypergonadotropic hypogenitalism. Two new varieties of this association are described.1. A syndrome of severe hypertension affecting three siblings (two sisters, one brother) is associated with hypogenitalism (ovarian agenesis and cryptorchism, respectively), decreased hearing, renal insufficiency, and decreased platelets adhesiveness. At autopsy of one sister a marked thymic hyperplasia and hypoplasia of several organs were found. Adrenals presented hyperplasia of zona glomerulosa and produced excessive deoxycorticosterone and compound "S". Plasma aldosterone and compound "S" secretion rate are... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Montreal Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 788-789KeywordsAldosteroneAutopsyBlood plasmaHearingHypertensionPlatelets Issue Published: 1 May 1970 PDF DownloadLoading ...
Abstract 4679: Novel pathway mutations in malignant mesothelioma revealed by high-throughput DNA and RNA sequencing
Authors: Akihiko Miyanaga, Mari Masuda, Koji Tsuta, Yuka Nakamura, Hisao Asamura, Akihiko Gemma, Tesshi Yamada
Journal: Cancer Research (2014)

Abstract Background: Malignant mesothelioma (MM) is an aggressive neoplasm associated with asbestos exposure. Because MM is usually diagnosed at an advanced stage and is largely unresponsive to conventional therapy, it is necessary to identify the signal pathways driving MM and to develop therapeutics specifically targeting these pathways. Materials and Methods: We carried out RNA sequencing of 12 MM cell lines and 4 clinical samples and exome sequencing of 6 MM cells using a so-called next-generation sequencer. We further performed pathway-targeted genome sequencing of 23 paired samples of MM tumor and normal tissue. Results: We identified 15 novel fusion genes by RNA sequencing and confirmed them by conventional Sanger sequencing and FISH analyses. We showed that the novel gene was included in both LOH and a fusion gene, and the gene which was critical tumor-suppressor roles caused two hit and was down-regulated. The gene has been identified as a central player of the emerging signaling pathway. We further identified the accumulation of mutations in 35% of the MMs by pathway-targeted genome sequencing. Conclusions: We indicated the need for the discovering molecular targets in the novel pathway in MMs. Our findings provide novel insights into the pathogenesis of MM and unequivocally demonstrate the power of sequencing technologies in cancer research. Citation Format: Akihiko Miyanaga, Mari Masuda, Koji Tsuta, Yuka Nakamura, Hisao Asamura, Akihiko Gemma, Tesshi Yamada. Novel pathway mutations in malignant mesothelioma revealed by high-throughput DNA and RNA sequencing. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4679. doi:10.1158/1538-7445.AM2014-4679
EMERGENCY SURGERY, WITH ESPECIAL REFERENCE TO WORK IN HOMES OF THE POOR.
Authors: R. C. DUGAN
Journal: JAMA (1899)

We have all heard the remark, and perhaps made it ourselves: "If we had the case in a hospital we would have operated, but could do nothing under the existing circumstances." The marvelously rapid improvement in hospitals and hospital equipments has made it possible to do a class of surgery that would be all but impossible in private houses, especially in those of the poor with small and perhaps dirty rooms. But, if we accept the responsibility of the care of the poor at all, it is our duty to do the very best for them that circumstances permit. Schiemelbusch and many others have shown that wound infection is caused by direct contact, and that we have little to fear from the air, unless large quantities of dust are flying. If, then, we carry with us, as we can, in a not very large satchel, previously-sterilized towels, sponge, pads, dressings,
Protection against pertussis by immunisation.
Authors: M W McKendrick, P R Gully, A M Geddes
Journal: BMJ (1980)

Review of all 126 children admitted to the communicable diseases unit with whooping cough during the epidemic in 1978 showed that two had received two doses of triple vaccine and only one had had full primary immunisation against the disease. None of these three children suffered complications of the disease. Of the 123 children who had not been immunised against pertussis, however, 66 had had one or more complications. In Birmingham the dramatic decline in immunisation against pertussis has been accompanied by a fall in acceptance rates for diphtheria and tetanus immunization. Nevertheless, of the 62 children aged over 1 year in this series, 41 had been so immunised. These findings suggest that the apparently positive decision by parents to omit pertussis immunisation was misplaced, since immunisation does protect against the more serious complications of the disease. Furthermore, there is no firm evidence that pertussis immunisation of children without specific contraindications is associated with serious adverse reactions.
Letter: Tolamolol in treatment of angina pectoris.
Authors: C Good
Journal: BMJ (1975)

reports a study of vitamin D consumption in different Norwegian population groups, in particular persons who had qualified for a disability pension because of myocardial infarction, angina pectoris, or degenerative joint disease.From his results Professor Linden concludes that a high in- take of vitamin D is a risk factor in the ocurrence of myocardial infarction and that 30 Mg a day is the critical level.'He found
Academic medicine: time for reinvention: Public health sciences need strengthening in developing countries
Authors: L. Dandona
Journal: BMJ (2004)

Editor—Bhutta's editorial highlights well the poor state of health systems and public health, and subsequent poor population health, in developing countries.1 The opportunity offered by BMJ's campaign to revive academic medicine,2 or more inclusively academic health care, needs to be captured, debated, and built on, particularly in developing countries, where this problem is greatest.

The key to taking this debate further would be to bring to public health sciences in developing countries the rigour and respect that is necessary to improve health systems and the health of populations. In India, for example, substantial talent is increasingly being tapped internationally, and systems have not been developed there to optimally use this talent for long term societal development. Thus India has brilliant basic scientists and clinicians but a poorly developed public health research and teaching system that lacks originality and substance and prevents fundamental improvements in population health. Currently, no coherent agenda exists for original and relevant research in the core disciplines of public health or in major visible public health problems.3-5 Without substantial original research, teaching in public health is not surprisingly bland and theoretical.

Without a cultural shift the development of research and teaching in public health sciences in India and many other developing countries will continue to fall far short of the requirement to improve population health. However, this shift will not come through hope alone or romanticising such ideas. The improvement in public health sciences will come about only if these sciences and their application earn respect through providing the substance that they are capable of.
MENTAL CONDITIONS FOLLOWING STRAIN AND NERVE SHOCK
Authors: R. G. Rows
Journal: BMJ (1916)

T44tIalthough he is not blind to them, -but that he is also unable to orientate or localize in space the positions of objects seen in the periplieral parts of the retina, and the relative positions of those that come in succession into central vision.This case consequently presents an apraxia of the oculo-motor movements similar to that described in the limbs, a defect in visual localization and orientation, and a failure of objects that stimulate the peripheral parts of the retinae to excite attention and the appropriate ocular movements.Althiough his lower limbs are apraxic in imitating move- ments made in front of him, in attempting movements to order, and especially in more complex actions, as in putting on his trousers, he can now walk easily, but proceeds only in short, shuffling steps, as though not confident of himself.His gait is, however, not ataxic.If left alone, he quickly deviates from the direction in which he wishes to go and runs into objects even thiough he is aware they are present.When, for instance, he is asked to walk between two rows of beds, he frequently turns to the right or to the left
Early exercise testing and coronary angiography after uncomplicated myocardial infarction.
Authors: F Akhras, J Upward, R Stott, G Jackson
Journal: BMJ (1982)

In a prospective study 61 patients aged 55 years or less with uncomplicated myocardial infarction underwent treadmill stress testing at two weeks and coronary angiography at six weeks after infarction. Of the 44 patients who had a positive stress test, 43 had additional severe coronary artery disease confirmed by coronary angiography. Of the 17 patients who had a negative stress test for additional disease, coronary angiography identified only single-vessel disease in the infarct area in 15. The sensitivity of the stress test was 95% and the specificity 94%, though the number of patients in the study was small. Thus, exercise testing has considerable potential for the early identification of multiple-vessel disease in patients with uncomplicated myocardial infarction.
Induction of Electrical Heterogeneity Impairs Ventricular Defibrillation
Authors: Michael R. Ujhelyi, J. Jason Sims, Allison Winecoff Miller
Journal: Circulation (1999)

Background —This study determined whether dispersion of conduction velocity, refractoriness, or excitability increases biphasic shock defibrillation energy requirements (DERs). Methods and Results —Twenty-four swine were instrumented with a mid-LAD perfusion catheter for regional infusion of lidocaine 0.75 mg · kg −1 · h −1 (n=7), low-dose d -sotalol (0.16 mg · kg −1 · h −1 ) (n=4), high-dose d -sotalol (0.5 mg · kg −1 · h −1 ) (n=6), or saline (n=7). Effective refractory periods (ERPs) were determined at 5 myocardial sites, and regional conduction velocity was determined in LAD-perfused and -nonperfused regions. Regional lidocaine infusion increased DER values by 84% ( P =0.008) and slowed conduction velocity by 23% to 35% ( P &lt;0.01) but did not affect ERP. Conversely, regional low- and high-dose d -sotalol infusion did not alter DER values or conduction velocity but increased regional ERP by 14% to 17% ( P &lt;0.001). Regional lidocaine increased conduction velocity dispersion by 100% to 200% ( P =0.01) but did not change ERP dispersion, whereas d -sotalol increased ERP dispersion by 140% ( P &lt;0.001) without affecting conduction velocity dispersion. Lidocaine infusion induced ventricular fibrillation (VF) in 6 of 7 animals, whereas regional d -sotalol was not proarrhythmic. Regional infusion of lidocaine and d -sotalol prolonged VF cycle length by 23% to 41% ( P &lt;0.05) in the perfused region and increased VF cycle length dispersion by 85% to 240% ( P &lt;0.05). Both agents increased pacing threshold (excitability) in the perfused region by 93% to 116% ( P &lt;0.05). Conclusions —Regional conduction velocity slowing increased DER values, which was probably a result of spatial dispersion of conduction velocity. Increasing refractory period dispersion without changing conduction velocity did not alter DFT values. Thus, dispersion of conduction velocity may be a more likely regulator of defibrillation efficacy than dispersion of refractoriness.
Effect of ferrous and ferric chelators on transferrin-iron-macrophage interactions
Authors: Roy D. Baynes, Brian M. Friedman, Gail T. Bukofzer, Thomas H. Bothwell, Bruce J. Macfarlane, Rosario D. Lamparelli
Journal: American Journal of Hematology (1988)

Abstract A study was done to evaluate the effect of ferrous and ferric chelators on the interaction between transferrin‐iron and cultured human blood monocytes. This interaction has been previously shown to involve a specific receptor and vesicle protonation. Transferrin‐iron uptake was significantly inhibited by the hydrophobic ferrous chelator 2,2′ bipyridine, and the inhibition was shown not to be a consequence of the mobilisation of intracellular iron by the chelator. Chase experiments and prolonged incubation studies suggested that the chelator prevented the iron released from transferrin from negotiating the unit membrane. The iron and transferrin then appeared to be returned independently to the incubation medium. In contrast, a hydrophilic ferrin chelator, desferrioxamine, had only a very modest effect on the interaction. These findings are compatible with the hypothesis that transferrin‐iron is reduced to the ferrous state during its uptake by the cultured human blood monocyte.