tbuckley/cabot-search huggingface dataset:
The development of clinical science in Britain.
Authors: C C Booth
Journal: BMJ (1979)

Clinical science is the study of man in health and disease.It also entails the use of experimental studies in animals when it is not possible to proceed further with human studies.As Sir Thomas Lewis claimed in his famous Harveian Oration on clinical science, its father was William Harvey.'Harvey had a free-ranging curiosity and liberality of mind that owed much to the freedom of thought encouraged at the Univer- sity of Padua at the beginning of the seventeenth century.An Anglican, he could have graduated from no other Italian univer- sity, where it was then necessary to be a Catholic to receive the university's degree.But Padua, enjoying the patronage of the Venetian Republic, was able to confer degrees that were not given by papal or ecclesiastical authority.It was this freedom from the authority of religion that made Padua the intellectual centre of Europe.Galileo was lecturing at Padua while Harvey was a student, but he probably never heard him, nor is it likely that he ever believed that the earth went round the sun.2Harvey graduated in 1602, returning to England and to a lifetime of practice in London.A year later the old queen died, to be succeeded by the first of the Stuarts, who arrived in London in May 1603.Harvey's experimental approach established for the first time the importance of experiment in medical research.Yet during the seventeenth century, little notice was taken by clinicians of the experimental method he had introduced, even after his death in 1657.Thomas Sydenham's descriptions of disease established a tradition of clinical observation in London medicine that was to last for over two centuries, but he was contemptuous of the new approach.Sir Hans Sloane, future president of both the Royal Society and the Royal College of Physicians, was intro- duced to him when a young man as a "good botanist and skilful anatomist," the basic sciences of those days.Thomas Sydenham told him: "Anatomy, botany, nonsense-no, young man go to the bedside; there alone can you learn disease."3This conversa- tion illustrates clearly the antithesis between the experimentalist and the experienced clinician-a conflict that sadly inhibited the development of academic medicine in medical schools in London until the twentieth century.In the second half of the seventeenth century, however, other developments began to influence clinical science.In 1663 the Royal Society was founded by Charles II, a forum for scientific discussion and debate of the first importance in this country.
Auto‐ and cross‐reactivity to thioredoxin allergens in allergic bronchopulmonary aspergillosis
Authors: A. G. Glaser, G. Menz, A. I. Kirsch, S. Zeller, R. Crameri, C. Rhyner
Journal: Allergy (2008)

Background: Thioredoxins are cross‐reactive allergens involved in the pathogenesis of atopic eczema and asthma. Cross‐reactivity to human thioredoxin can contribute to the exacerbation of severe atopic diseases. Methods: Human thioredoxin, Asp f28 and Asp f29, two thioredoxins of Aspergillus fumigatus , and thioredoxin of Malassezia sympodialis were cloned and produced as recombinant proteins. Allergenicity and cross‐reactivity to thioredoxins in allergic bronchopulmonary aspergillosis patients were assessed by enzyme‐linked immunosorbent assay (ELISA), inhibition ELISA, immunoblot analysis, proliferation assays and skin tests. Molecular homology modelling was used to identify conserved, surface‐exposed amino acids potentially involved in immunoglobulin E (IgE)‐binding. Results: All thioredoxins, including the human enzyme, bind IgE from patients with allergic bronchopulmonary aspergillosis and induce allergen‐specific proliferation in peripheral blood mononuclear cells and positive skin reactions in thioredoxin‐sensitized patients. Inhibition experiments showed that the thioredoxins are cross‐reactive indicating humoral immune responses based on molecular mimicry. To identify structural surface elements involved in cross‐reactivity, the three‐dimensional structures were modelled based on solved thioredoxin structures. Analysis of the molecular surfaces combined with sequence alignments allowed identification of conserved solvent exposed amino acids distantly located in the linear sequences which cluster to patches of continuous surface areas. The size of the surface areas conserved between human and fungal thioredoxins correlates well with the inhibitory potential of the molecules in inhibition ELISA indicating that the shared amino acids are involved in IgE‐binding. Conclusions: Conserved, solvent exposed residues shared between different thioredoxins cluster to continuous surface regions potentially forming cross‐reactive conformational B‐cell epitopes responsible for IgE‐mediated cross‐reactivity and autoreactivity.
Alveolar macrophage kinetics after inhalation of 239PuO2 by CBA/Ca mice: changes in synthesis of DNA.
Authors: J P Kellington, K Gibson, T M Buckle, R J Talbot, S B Hornby
Journal: Environmental Health Perspectives (1992)

For workers in the nuclear industry, the primary route for the entry of radioactive materials into the body is by inhalation, and the rate of clearance of particles from the pulmonary region of the lung is an important factor in determining radiation dose. It is the function of alveolar macrophages (AM) to maintain the sterility of the lung and to remove insoluble particles from the respiratory surfaces and airways. The AM population is not static, and under normal conditions the loss of macrophages from the alveoli via the conducting airways is balanced by renewal. Studies of the effects of external irradiation on the kinetics of AM are numerous, but to date little is known about the effects of inhaled radioactive particles. In this investigation the effects of inhaled 239PuO2 (plutonium dioxide) particles on the synthesis of DNA by AM were studied at times up to 77 days after exposure. We also measured the number of cells recovered by bronchoalveolar lavage and the incidence of AM with nuclear aberrations. The latter provides a sensitive indicator of the effects of radiation. One of the earliest effects observed after exposure to 239PuO2 is a reduction in the number of AM recovered by lavage. This reduction is associated with a 3-fold reduction in the proportion of AM undergoing DNA synthesis at early times after exposure. The overall mean pulse labeling index of AM recovered from sham-exposed mice is 1.68%, and no trend is observed with time.(ABSTRACT TRUNCATED AT 250 WORDS)
Health and Justice Professionals Set Goals to Lessen Domestic Violence
Authors: Charles Marwick
Journal: JAMA (1994)

IT'S AN OLD story—one that members of the healing, teaching, social service, and legal professions in particular would like to see come to an end. For many years Mary (not her real name) was abused by her husband psychologically and physically. She went to the police for help, without success. She sought assistance from her church, with equal lack of success. Finally, Mary got a job and decided to leave the abusive relationship. She got legal advice and obtained a court order of restraint against her husband, then moved out of town. A few weeks later, Mary's husband tracked her down and shot her dead. The man escaped legal punishment on grounds of temporary insanity. This story was related by Palma E. Formica, MD, a family physician who practices in Old Bridge, NJ, at the National Conference on Family Violence: Health and Justice, held last month in Washington, DC. "Mary
Recent Advances in Gastroenterology
Authors: Sumner C. Kraft
Journal: JAMA (1966)

This collection of review articles will interest those concerned with gastrointestinal function in health and disease. The discussions do, indeed, reflect recent advances, and are comprehensively presented by 21 authorities, for the most part from England. The 18 topics include genetics and gastroenterology, enzyme deficiency in the small intestine, protein-losing enteropathy, the dynamics of the small-intestinal mucosa, liver disease in ulcerative colitis, the management of an ileostomy, the surgery of portal hypertension, and the biochemical aspects of pancreatitis. This work points out that gastroenterology is a dynamic field in which physicians, surgeons, biochemists, geneticists, immunologists, and many others have become jointly involved.  The editors admittedly have not attempted to produce a work of unformity, to be read in sequence from beginning to end. Instead, each topic has been analytically reviewed with frequent citation of original data. The result is an easy-to-read volume of much theoretical and some practical interest. In
Recognition of Emotional Disturbance and the Prevention of Suicide
Authors: A. Capstick
Journal: BMJ (1960)

More than 5,000 persons die annually by their own hand in England and Wales, and there is reason to suppose that their number will increase as the age structure of the population changes (Swinscow, 1951).There is no doubt about the size of the problem of suicide or of its claims for attention.Sainsbury (1955) examined the social factors which favour suicide and suggested fields of study which might lead to the prevention of suicide through a programme of mental hygiene, but can any substantial proportion of the present toll of suicides be prevented now by medical action ?The answer must depend upon how many potential suicides show signs which are recognizable as danger signals calling for medical help, how many of these danger signals are recognized as such, and how many would-be suicides, if recognized as emotionally ill, are then responsive to psychiatric treatment.
Treatment of duodenal ulceration: reflections, recollections, and reminiscences.
Authors: K D Bardhan
Journal: Gut (1989)

This idiosyncratic contribution is a highly personal view of some of the developments that have taken place in the field of duodenal ulcer disease, particu- larly its management, which havc bcen of intercst to me.Work done in Rotherham has been cited not because it is of particular merit but because such reference is unavoidable in a personal view; and for the same reason there is disproportionate discussion of cimetidine, for that is the drug with the longest scientific history and the compound with which I am most familiar.My interest in ulcer disease started as a medical student in the Christian Medical College at Vellore, South India, where the condition was rife.At a chance meeting with Dr Booth, (as he then was) who was visiting Vellore, he mentioned in passing that if I wanted to pursue the subject I should learn the importance of the scientific method and not practice medicine solely as an art.When I became his houseman a few years later he reinforced this lesson but it was not until I got to Rotherham that I got a chance to renew my interest in duodenal ulcer disease.At that time this disorder attracted little attention from physicians.Unfortunately, I started work on the pathophysiology of the disease, rather than on the therapy, on the grounds that there were unlikely to be any new major advances in treatment!My involvement with cimetidine, therefore, arose purely by accident.
Money must be made available for NICE guidance, minister says
Authors: C. Shannon
Journal: BMJ (2003)

Health minister Norman Warner announced last week that he is taking steps to ensure that health organisations make the necessary financial arrangements for the implementation of the recommendations of the National Institute for Clinical Excellence (NICE).

Since its inception in 1999 NICE has issued guidance on the use of over 200 drugs and treatments. With some exceptions the NHS in England and Wales is required to provide any treatments endorsed by NICE within three months of the institute's decision, but in reality the NHS has struggled to keep up with the pace of the institute's outputs.

Patients' organisations, the drugs industry, and many clinicians have been growing impatient with the slow …
A RERORT OF THREE SUPRA-VAGINAL HYSTERECTOMIES AND SIMILAR CASES TREATED BY ELECTROLYSIS.Read in the Section of Obstetrics and Diseases of Women, at the Forty-second Annual Meeting of the American Medical Association, held at Washington, D. C., May, 1891.
Authors: THOMAS OPIE
Journal: JAMA (1891)

Mrs. L., age 48, was married at 28. Menstruation began at 16. This function continued regularly, painlessly, normally, throughout her unmarried life and during her married life until six months ago, when she began to menstruate on alternate months. She never conceived during her 22 years of married life, though her husband was a healthy man and both enjoyed to the fullest extent the conditions of sexual union. Five years ago, she first noticed an enlargement of the abdomen; she observed that she was "short-waisted." Pressure symptoms manifested themselves in disturbances of the digestive system two years ago and were her only annoyance, save the mortification growing out of her abdominal development. There has been no vesical nor renal disturbance, at least so far as the patient remembers, because, like the uterus of advanced pregnancy, it has for five or six years been an occupant of the abdominal cavity. The
P151 Cost of pulmonary rehabilitation is offset by reduction in healthcare utilisation
Authors: S. Kibe, D. Frost, S. Hart
Journal: Thorax (2011)

<h3></h3> 151 patients completed pulmonary rehabilitation over a period of over 4 years at our hospital. Retrospective analysis of 71 patients from this group was done. This showed that there was a significant difference between pre and post rehabilitation in FVC, VC, HADS depression score &amp; SWT (shuttle walk test distance). Analysis of a sub group of 37 patients at 6 months after pulmonary rehabilitation showed that there were still significant differences in HADS depression &amp; SWT, but not the other variables. We were able to establish a significant reduction in healthcare utilisation, both in hospital admissions and in out patient attendances. This was independent of the reported level of benefit on CRDQ scores. “Responders” (patients with a more than 1.5 increase in each of their CRDQ scores) had similar reduction in healthcare utilisation compared to “non-responders” (patients with &lt;0.5 difference or deterioration in their CRDQ scores). At our hospital the approximate cost of pulmonary rehabilitation is 375 pounds per person. Out patient (respiratory) appointments and hospital admissions were noted for 1 year prior to and 1 year post rehabilitation. Our data showed that there was a 74% reduction in hospital admissions and a 51% reduction in out patient follow-up appointments in the 1-year after pulmonary rehabilitation. Our calculations showed that pulmonary rehabilitation was a cost effective intervention. In an attempt to identify patients who would respond well/poorly to pulmonary rehabilitation we looked at the baseline characteristics of “responders” vs “non responders”. <h3>Responders</h3> Mean age 67.4 (range 50–82), mean FEV1 −0.84 (range 0.38–1.6), (FEV1%−37.2), mean FVC −1.93 (range 0.8–2.96), (FVC% 64), mean VC −2.08 (range 1.03–3.17), 54% were male, 46% female, 36% lived alone, mean pack years smoked 36.9 (range 0–80). <h3>Non responders</h3> Mean age 68 (range 44–80), mean FEV1 −1.29 (range 0.65–3.11), (FEV1%−45.9), mean FVC −2.51 (range 0.86–3.65), (FVC% 79.1), mean VC −2.71 (range 0.98–4.67), 50% were male, 50% female, 31% lived alone, mean pack years smoked 27.46 (range 1–80). This study raises questions with regard to the importance of current CRDQ assessment in rehabilitation. It also shows that the cost of pulmonary rehabilitation is at least offset by reduction in healthcare utilisation.
Purulent Pericarditis: a Complication of Endoscopic Oesophageal Variceal Sclerotherapy
Authors: S. Gupta, K. Thompson, L. Grellier
Journal: Endoscopy (2005)

A 63-year-old woman with portal hypertension secondary to alcoholic cirrhosis underwent oesophageal variceal sclerotherapy with 5 % ethanolamine oleate. She developed prolonged retrosternal pleuritic chest pain, with dyspnoea. Clinical examination revealed tachypnoea, tachycardia, and crepitations at the left lung base. Arterial blood gas analysis showed hypoxia of 7.7 mm Hg (normal range 11.1 - 14.4 mm Hg), but the chest radiograph and electrocardiogram were normal. Since the D-dimer level was raised, a computed tomography (CT) pulmonary angiogram was carried out, which was negative for pulmonary embolism but showed pericardial and pleural effusions (Figure [1]). The patient developed septicaemia with a temperature, tachycardia and hypotension, and had a raised white cell count and C-reactive protein level. Antibiotic treatment was started. She then developed signs of pericardial tamponade, with a raised jugulovenous pulse and muffled heart sounds. An echocardiogram showed a pericardial effusion 3.4 cm in size, with no features of tamponade. A therapeutic pericardiocentesis revealed purulent fluid, which grew coliform bacilli and Bacteroides species. A Gastrografin swallow on day 9 was normal. The patient underwent anterior thoracotomy with pericardiectomy, and made a slow but complete recovery.
Skin Exposure to Isocyanates: Reasons for Concern
Authors: Dhimiter Bello, Christina A. Herrick, Thomas J. Smith, Susan R. Woskie, Robert P. Streicher, Mark R. Cullen, Youcheng Liu, Carrie A. Redlich
Journal: Environmental Health Perspectives (2006)

Isocyanates (di- and poly-), important chemicals used worldwide to produce polyurethane products, are a leading cause of occupational asthma. Respiratory exposures have been reduced through improved hygiene controls and the use of less-volatile isocyanates. Yet isocyanate asthma continues to occur, not uncommonly in settings with minimal inhalation exposure but opportunity for skin exposure. In this review we evaluate the potential role of skin exposure in the development of isocyanate asthma.We reviewed the published animal and human literature on isocyanate skin-exposure methods, workplace skin exposure, skin absorption, and the role of skin exposure in isocyanate sensitization and asthma.We selected relevant articles from computerized searches on Medline, U.S. Environmental Protection Agency, Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, and Google databases using the keywords "isocyanate," "asthma," "skin," "sensitization," and other synonymous terms, and our own extensive collection of isocyanate publications.Isocyanate production and use continues to increase as the polyurethane industry expands. There is substantial opportunity for isocyanate skin exposure in many work settings, but such exposure is challenging to quantify and continues to be underappreciated. Isocyanate skin exposure can occur at work, even with the use of personal protective equipment, and may also occur with consumer use of certain isocyanate products. In animals, isocyanate skin exposure is an efficient route to induce sensitization, with subsequent inhalation challenge resulting in asthma-like responses. Several lines of evidence support a similar role for human isocyanate skin exposure, namely, that such exposure occurs and can contribute to the development of isocyanate asthma in certain settings, presumably by inducing systemic sensitization.Integrated animal and human research is needed to better understand the role of skin exposure in human isocyanate asthma and to improve diagnosis and prevention. In spite of substantial research needs, sufficient evidence already exists to justify greater emphasis on the potential risks of isocyanate skin exposure and the importance of preventing such exposures at work and during consumer use of certain isocyanate products.
The Proportion of Night Labors.
Authors: C. H. Preston
Journal: JAMA (1905)

Davenport, Iowa, Oct. 14, 1905. <h3>To the Editor:</h3> —InThe Journalof this date you refer to White, who considers the idea that a majority of labors terminate at night as probably fallacious and suggests a further consideration of statistics. In the<i>Medical News</i>, Sept. 12, 1891, Dr. G. W. H. Kemper recorded the statistics of 1,000 consecutive cases, 13 of which were twins, the hour of two births not recorded, leaving a total of 1,011 births. Dividing the day into six-hour periods beginning at midnight, there were in the first 291, in the second 267, in the third 222, and in the fourth 231 births, being an excess of 33 in favor of the night hours. Of the 250 consecutive labors of which I have kept notes 81 terminated in the first quarter of the day, 68 in the second, 43 in the third and 58 in the fourth,
Understanding Medical Research: A Practitioner's Guide
Authors: Lou Fintor
Journal: Annals of Internal Medicine (1998)

Medical Writings: Book Notes1 January 1998Understanding Medical Research: A Practitioner's GuideLou Fintor, MA, MPHLou Fintor, MA, MPHCenters for Disease Control and Prevention, Morgantown, West Virginia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-1-199801010-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Garb JL. 256 pages. Boston: Little, Brown; 1996. $24.95. ISBN 0316291692.Field of medicine: Epidemiology and the clinical specialties.Format: Softcover book.Audience: Written for busy clinical practitioners, this book is also useful for medical students and others who desire a brief, general overview of the fundamental epidemiologic and statistical tools necessary for understanding and critically evaluating medical literature.Purpose: To “demystify” statistics and “provide clinicians with the practical skills to evaluate studies in the medical literature or to conduct studies for publication.”Content: The 16 chapters of this book are grouped into four sections: “Principles of Estimation,” “Principles of ... Author, Article, and Disclosure InformationAffiliations: Centers for Disease Control and Prevention, Morgantown, West Virginia. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1998Volume 128, Issue 1Page: 79KeywordsChartsClinical epidemiologyConfidence intervalsEpidemiological methods and statisticsRelative riskReproducibilityResearch designStatistical dataStatistical methodsTest statistics ePublished: 15 August 2000 Issue Published: 1 January 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Relationship of erosive gastritis to the acid secreting area and intestinal metaplasia, and the healing effect of pirenzepine.
Authors: M Tatsuta, H Iishi, S Okuda
Journal: Gut (1987)

The extent of acid secreting areas and the distribution of intestinal metaplasia in patients with erosive gastritis, and the healing effects of pirenzepine were examined. Studies were done with the endoscopic Congo red-methylene blue test developed in our hospital. Compared with control patients with no gastroduodenal disease, erosive gastritis was associated significantly more frequently with large acid secreting areas, but little or no intestinal metaplasia was detected in the stomach. A double blind trial was carried out, using 100 mg pirenzepine tablets or placebo for three months in 43 patients with erosive gastritis. Endoscopically, complete healing was significantly more frequent in the pirenzepine treated groups three months after the start of the treatment, as compared with the placebo treated group (p less than 0.05).