tbuckley/cabot-search huggingface dataset:
TCT-381 Optical coherence tomography for the early detection of cardiac allograft vasculopathy after heart trasplant
Authors: Esther Sánchez Insa, Georgina Fuertes Ferre, José G. Galache Osuna, Juan Sánchez-Rubio Lezcano, José A. Diarte de Miguel, Eduardo Lezcano Callen, Isabel Calvo-Cebollero
Journal: Journal of the American College of Cardiology (2014)
Sleep and a Bedtime Beverage
Authors: A. Petrie
Journal: BMJ (1972)

piss pills"-most commonly frusemide without potassium supplements.The diuretics may be taken only before the weigh-in, or ingested regularly.Those who do the latter complain of the decrease in efficacy which is a natural consequence of potassium depletion.Purgation is often practised on the morning of the race with potassium depletion consequent upon its effects.Although hyperkalaemia is more dan- gerous any change in the potassium status of the individual may change his E.C.G. and those doctors who have jockeys as patients should be aware of the incidence of self-medication.-Iam, etc.,
Total and Differential Protein Levels in the Blood and Cerebrospinal Fluid in Rheumatoid Arthritis
Authors: B. Lush, M. F. Crowley, E. Fletcher, J. F. Buchan
Journal: Annals of the Rheumatic Diseases (1951)

OBJECTIVES: To determine the relationship between biochemical markers of bone metabolism and statural growth, and their suitability as surrogate markers of inhaled corticosteroid induced growth suppression. DESIGN: Randomised, double blind, placebo controlled comparison of inhaled beclomethasone dipropionate 200 micrograms twice daily as dry powder for six months. SETTING: Southampton. OUTCOME MEASURES: Serum osteocalcin, urinary deoxypyridinoline, and statural growth. SUBJECTS: 7 to 9 year old children with recurrent wheeze. RESULTS: There were no significant differences in serum osteocalcin between the beclomethasone dipropionate and placebo group measured at baseline or after three and six months9 treatment, while deoxy-pyridinoline was significantly higher in the placebo treated children after three months. Growth was significantly decreased in the beclomethasone dipropionate group over the course of the study. Growth over the six months, both in those receiving beclomethasone dipropionate and those receiving placebo, was significantly correlated with serum osteocalcin measured at three months and six months. CONCLUSION: Although serum osteocalcin shows excellent correlation with growth, it is a poor marker for decreased growth associated with use of inhaled corticosteroids.
Matrix metalloproteinases and TIMP in acute respiratory distress syndrome.
Authors: B Ricou, L Nicod, S Lacraz, H G Welgus, P M Suter, J M Dayer
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

To investigate the implication of extracellular matrix proteinases in acute respiratory distress syndrome (ARDS), we determined 92 kD gelatinase (92 G'ase) and its natural antagonist, the tissue inhibitor of metalloproteinases-1 (TIMP) in bronchoalveolar lavage fluid (BALF) and plasma of 33 intensive care unit (ICU) patients presenting with trauma or septic shock. Eleven of these patients developed short-course ARDS, nine developed prolonged ARDS, and 13 did not progress to ARDS. Ten non-ICU patients served as controls. During the early phase of disease, 92 G'ase in BALF of ICU patients was higher than in controls, but plasma levels were not different. TIMP was increased in BALF and plasma in ARDS as compared with those of patients at risk. The 92 G'ase/TIMP ratio in BALF remained elevated in late phases of prolonged ARDS. The high intrapulmonary levels of 92 G'ase in patients at risk and with ARDS may reflect increased turnover of extracellular matrix in acute lung injury. Increased TIMP may interfere with tissue repair and fibrosis by its inhibition of 92 G'ase. Interleukin-6 (IL-6) could be involved in enhanced local synthesis of TIMP. The balance between 92 G'ase and TIMP may play an important role in lung remodeling, which is characteristic of ARDS.
A Revival of the Kansas Case.
Authors: J. M. Madden
Journal: JAMA (1897)

Milwaukee, Wis., March 22, 1897. <h3>To the Editor:</h3> —In your issue of the 20th inst., you speak of the " Kansas Hypnotism Case" and say that it was "one of the first in which the plea of hypnotic influence had been employed by the prosecution in the criminal courts." In the Journal for June 8, 1895 (p. 903) you published a letter written by me in which the points discussed in the supreme court of Kansas were quoted and the law journal in which the case first appeared was named. It was then shown that the supreme court had nowhere, in its summing up of the testimony, mentioned the subject of hypnotism. Soon after the publication of this letter, some magazine, which I can not now recall, published an interview with the trial judge of the case; and he rather emphatically denounced the story that the plea of hypnotism was entertained
Sugary drinks, fruit, and increased risk of gout
Authors: Martin Underwood
Journal: BMJ (2008)

INTRODUCTION: Gout affects about 5% of men and 1% of women, with up to 80% of people experiencing a recurrent attack within 3 years.METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute gout?What are the effects of treatments to prevent gout in people with prior acute episodes?We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review).We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).RESULTS: We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria.We performed a GRADE evaluation of the quality of evidence for interventions.CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: colchicine, corticosteroids, corticotrophin (ACTH), non-steroidal anti-inflammatory drugs (NSAIDs), sulfinpyrazone, xanthine oxidase inhibitors, advice to lose weight, advice to reduce alcohol intake, advice to reduce dietary intake of purines. QUESTIONS
Multimedia: The Last Resort: Psychosurgery and the Limits of Medicine
Authors: Grant Gillett
Journal: BMJ (1999)

Jack D Pressman


Cambridge University Press, £40, pp 572 




ISBN 0 521 35371 8

———————

Rating: ★★★★

Psychosurgery forms an intriguing chapter in 20th century medicine that involved an alliance between psychiatrists, neurosurgeons, and neuroscientists in an attempt to help a desperate group of patients. Its rise and fall is an exemplary tale that reveals the scientific and intellectual status of clinical science. For that reason it is of interest far beyond the bounds of the specialties concerned. Jack Pressman tells this tale with a blend of historical ability and acumen that preserves him from the simplistic thinking of scientists attempting to write the history of medicine.

Pressman traces the course of psychosurgery in a way that rings true for any clinician, bringing out the complex factors involved in the acceptance of any medical innovation. He identifies a convergence between a theoretical bias toward hard biological science, suggestive experiments favouring a certain conclusion, and then a bold and dramatic clinical venture that initially seemed to have beneficial effects. He carefully charts the way in which “the procedure’s fate also became wrapped up in the currents driving psychiatry.” Among these were the revisioning of psychiatric disorder as maladjustment, the need to have some positive treatments to offer a hopeless remnant of patients, and the growing numbers of these chronic patients in state psychiatric hospitals. This, after some early and dramatic successes, made the lobotomy rate an indicator of the extent to which an institution was keeping up with modern trends in the care of patients.

Pressman discusses the difficulties of assessing outcomes and therapeutic effectiveness in psychiatry and the entwined intellectual, pragmatic, and social content in any medical advance. He distils a deep lesson for clinical science in general. We tend to see medicine as a smooth progress of the scientific method in which we discern and transcend the ignorance and therapeutic limitations of the past, but this is not so. In every age we are pushed and pulled by theoretical and therapeutic fashions, and what may seem like an exciting and innovative treatment at some point may later be viewed as not only obsolete but also barbaric.

Clinicians must somehow retain both scientific objectivity and an attitude of care for their patients in the face of this uncertainty. Healthy scepticism can be indiscernible from reactionary entrenchment in soon-to-be-outmoded ideas, and yet enthusiastic adoption of the new can lead to tragedy and suffering. Nevertheless, we go on into uncharted territory, where the waywardness of our path may be revealed only by a map drawn with the benefit of hindsight. Seen in this way, the story of lobotomy is the story of clinical medicine as we know it.
PWE-068 Angiographic embolisation for non-variceal upper gastrointestinal haemorrhage after failed endoscopic therapy—a 5-year district general hospital experience
Authors: S Chatterjee, L Potti, R Raza, F P Perez, D Majumdar, S Hall, D Dwarakanath, C Wells, J Hancock, D Ashley, B K Chaudhury, J Latimer
Journal: Gut (2012)

<h3>Introduction</h3> The recent nationwide upper gastrointestinal bleeding audit found that interventional radiology for bleeders are minimally utilised. In our hospital, we have had this service during normal working hours since 2007. This study reviews our experience. <h3>Methods</h3> We retrospectively reviewed the case notes of all patients who had mesenteric angiogram in our hospital for treatment of gastrointestinal bleeding since 2007. All data were analysed using SPSS V.17 statistical software. <h3>Results</h3> We identified 32 patients. Three case notes were not available hence, 29 patients were included in this study (19 Male, 10 Female). Mean age group 75 years (Range 40–89). Mean Rockall score was 7 and mean Blatchford score was 12. 15 patients (52%) went straight for radiological embolisation after one attempt at therapeutic endoscopy. Eight patients (22%) were ITU admissions. Final Diagnosis was duodenal ulcer in 22 (76%), gastric ulcer in 6 (21%) and Duodenal Cancer in 1 (3%). Extravasation of contrast at angiogram was seen in only 7% of cases. Gastroduodenal artery was embolised in 25 (87%), left gastric artery in 3 (10%) and Rt gastro-epiploic artery in 1 (3%). No immediate complications were noted as a result of the procedure. Rebleeding was noted in 8 pts (27%). 24 patients (83%) survived more than 30 days. Four (14%) died within 7 days of the procedure and 1 (3%) died after 7 days. 40% (2 out of 5) died of a cause unrelated to rebleed. <h3>Conclusion</h3> Our study demonstrates success at embolisation and mortality rates similar to the published results of the UK nationwide GI bleeding audit. We believe access to interventional radiology is an important therapeutic strategy that should be available in all hospitals admitting GI bleeders. <h3>Competing interests</h3> None declared.
Human Guinea Pigs
Authors: M. Eastwood
Journal: BMJ (2009)

The 19th century physician in England was a comfortable gentleman, educated in the classics and well versed in medical practices unchallenged since Greek and Roman times. In the early 20th century a few talented doctors saw the need for science in effective clinical practice. This knowledge was to be obtained by experiments on human subjects. They were full of zeal; and because of their intellect and prowess and the sheer excitement of their findings they were in turn unchallenged. Until, that is, Maurice Pappworth in London and Henry Beecher of Harvard University looked …
PULMONARY EMBOLISM BY AMNIOTIC FLUID
Authors: Duncan E. Reid
Journal: JAMA (1953)

<h3>To the Editor:</h3> —InThe Journal, Nov. 1, page 943, appeared an editorial entitled "Pulmonary Embolism by Amniotic Fluid." The syndrome, the lethal aspects, and certain of the causative factors were discussed. In accordance with the conclusions of Steiner and Lushbaugh, who first described the clinical and morphological aspects of the syndrome, death was ascribed to anaphylactic reaction and to the toxicity of the amniotic fluid. The editorial was careful to explain, however, that the etiology of the condition and the cause of death had not been definitely established. Finally, reference was made to the often-held opinion that the diagnosis of amniotic fluid embolism is questionable, short of autopsy evidence.
Dependence on Cyanocobalamin Injections
Authors: Sarko M. Tilkian
Journal: JAMA (1989)

<h3>To the Editor. —</h3> I started reading the article by Drs Lawhorne and Ringdahl<sup>1</sup>with interest. By the time I finished, I was angry and depressed enough to write this letter. Throughout the article, there was no mention of how vitamin B<sub>12</sub>deficiency can be scientifically assessed for clinical purposes. Current practice seems to emphasize the art of medicine, and also the economics of medicine under the guise of cost containment, at the expense of science. The workup of a patient with vitamin B<sub>12</sub>problems can be expensive and inconclusive, but it can also be objective and scientific with minimum cost.<sup>2</sup>One does not have to do Schilling or deoxyuridine suppression tests, measure vitamin B<sub>12</sub>levels, perform gastrointestinal series, etc, which are expensive and sometimes uninformative. There are simple tests that every physician orders routinely but perhaps does not look at critically. For example, the
Localization of the iron transport proteins mobilferrin and DMT‐1 in the duodenum: The surprising role of mucin
Authors: Marcia Simovich, Lucille N. Hainsworth, P.A. Fields, Jay N. Umbreit, Marcel E. Conrad
Journal: American Journal of Hematology (2003)

Abstract There are two pathways for inorganic iron uptake in the intestine, the ferric pathway, mediated by the key protein mobilferrin, and the ferrous pathway, mediated by DMT‐1. Previous studies reported that the amount of DMT‐1 increased in the intestinal mucosa in iron deficiency and the increase was seen in the apical portion of the villus of the duodenal mucosa. Mobilferrin did not quantitatively increase but became localized at the cell membrane. However, studies on fresh tissue have not previously been performed and the localization to the microvillae has not been demonstrated. In order to more definitively localize these proteins immunofluorescent and electron microscopic studies were undertaken. Samples were also subjected to biochemical analysis and Western analysis. In iron‐deficient animals both DMT‐1 and Mobilferrin were concentrated in the apical surface of the villae. Electron microscopy revealed that the majority of this increase in the amount of these proteins near the luminal surface was due to increased binding of the proteins to mucin in vesicles near the surface. A significant portion of the iron transport proteins was localized in the goblet cells and outside the cell in the luminal mucin, as demonstrated by immunofluorescence, electron microscopy, and isolation of the mucin by cesium chloride gradient centrifugation and Western analysis. A new model for the transport of metal ions was suggested. The metal transport proteins travel from vesicles inside the cell out to the lumen mucin. This increases the surface area and allows a greater portion of the lumen contents to be exposed to the binding proteins. Once the metal is bound to the externalized protein it is internalized into the cell. This explains many of the unique properties of the iron‐binding proteins and suggests that it may be a more general model for the absorption of other nutrients. Am. J. Hematol. 74:32–45, 2003. © 2003 Wiley‐Liss, Inc.
Multiple Sclerosis and Exposure to House Pets
Authors: Seymour Jotkowitz
Journal: JAMA (1977)

<h3>To the Editor. —</h3> In an elegant epidemiologic study, Cook and Dowling<sup>1</sup>recently showed a strong correlation between familial multiple sclerosis and exposure to small house pets. The present study may confirm this data and extend it to sporadic cases. Fifty multiple sclerosis patients were questioned. Forty-six (92%) had close contact with a house pet, usually within five (or ten) years prior to the onset of their illness. Only 24 of 50 (48%) in the control group (consisting of patients with migraine, epilepsy, or low back pain and of about the same age and sex) had similar contact. This difference is highly significant (<i>P</i>&lt;.001). The incidence of contact with sick dogs in the multiple sclerosis series was impressive. Several patients reported that a diagnosis of distemper was actually made for their dog within several years of the onset of their illness. Because of the vagueness of the canine
New Normal Values for Thyroid Uptake of Radioactive Iodine
Authors: Gary G. Ghahremani
Journal: JAMA (1971)

A 24-hour thyroid uptake test of sodium iodide I131 performed on 66 euthyroid subjects in Chicago has been analyzed. The new normal range, based on mean ± 2 standard deviations is 7% to 33%, which could explain the discrepancies between patient's clinical status and the results of the uptake test if data previously considered normal (15% to 45%), were applied.
National Health Service — A Clinician's View
Authors: John Lister
Journal: New England Journal of Medicine (1973)

As Battistella and Chester point out in their comprehensive review (p. 610), the act to reorganize the National Health Service (NHS) becomes effective on April 1, 1974. The present tripartite structure of the NHS will then disappear, and the hospitals, the general-practitioner service and the community health services will be administered by the same authority. The Department of Health will continue to make policy decisions, but authority will be delegated downward to Regional Health Authorities (RHA), Area Health Authorities (AHA) and districts where multidisciplinary District Management Teams (DMT) will take executive action in line with policies defined by Regional and . . .
The Corrigan Sign
Authors: Richard Allen Dickey
Journal: JAMA (1969)

<h3>To the Editor:—</h3> In your biographical sketch of Sir Dominic Corrigan (<b>208</b>: 1152, 1969), you note his description of "the visible pulsations of an aneurysm of the aortic arch" as noted over the carotid arteries. You refer to this as the Corrigan sign. You further state that Sir Dominic's best known eponym was associated with aortic regurgitation. In fact, the water-hammer pulse, the collapsing pulse, or the pulsus celer associated with aortic insufficiency has been incorrectly termed the Corrigan pulse. While Corrigan did, in 1833 at age 30, describe the visible abrupt distention and quick collapse of the carotid arteries in patients with aortic insufficiency, the similarity of the palpable characteristics of the pulse in aortic insufficiency and that of a 19th century water-hammer toy was pointed out by Thomas Watson 11 years later in 1844. Accordingly, it is suggested that the eponym "Watson pulse" be appropriately substituted for Corrigan
Home care during the pancytopenic phase after allogeneic hematopoietic stem cell transplantation is advantageous compared with hospital care
Authors: Britt-Marie Svahn, Mats Remberger, Karl-Erik Myrbäck, Katarina Holmberg, Britta Eriksson, Patrik Hentschke, Johan Aschan, Lisbeth Barkholt, Olle Ringdén
Journal: Blood (2002)
Richard James Lance Davis
Authors: S. Warnke
Journal: BMJ (2009)

Richard James Lance Davis—known as Jim—took a commission in the Royal Marines on 1 September 1939. Sunk on HMS Repulse in December 1941, he took part in various escapades in Malaya before the fall of Singapore, when he became a prisoner of war.

Jim studied medicine at St John’s, Cambridge, during 1946-9, and claimed to have been educated on the Burma-Thailand railway and …
Neurobehavioral performance and work experience in Florida farmworkers.
Authors: Freya Kamel, Andrew S Rowland, Lawrence P Park, W Kent Anger, Donna D Baird, Beth C Gladen, Tirso Moreno, Lillian Stallone, Dale P Sandler
Journal: Environmental Health Perspectives (2003)

Farmworkers experience many work-related hazards, including exposure to neurotoxicants. We compared neurobehavioral performance of 288 farmworkers in central Florida who had done farm work for at least 1 month with 51 controls who had not. Most of the farmworkers had worked in one or more of three types of agriculture: ornamental ferns, nurseries, or citrus fruit. We collected information on farm work history in a structured interview and evaluated neurobehavioral performance using a battery of eight tests. Analyses were adjusted for established confounders including age, sex, education, and acculturation. Ever having done farm work was associated with poor performance on four tests--digit span [odds ratio (OR) = 1.90; 95% confidence interval (CI), 1.02-3.53], tapping (coefficient = 4.13; 95% CI, 0.00-8.27), Santa Ana test (coefficient = 1.34; 95% CI, 0.29-2.39), and postural sway (coefficient = 4.74; 95% CI, -2.20 to 11.7)--but had little effect on four others: symbol digit latency, vibrotactile threshold, visual contrast sensitivity, and grip strength. Associations with farm work were similar in magnitude to associations with personal characteristics such as age and sex. Longer duration of farm work was associated with worse performance. Associations with fern work were more consistent than associations with nursery or citrus work. Deficits related to the duration of work experience were seen in former as well as current farmworkers, and decreased performance was related to chronic exposure even in the absence of a history of pesticide poisoning. We conclude that long-term experience of farm work is associated with measurable deficits in cognitive and psychomotor function.
Effect of distance from surgery on consultation rates in an urban practice.
Authors: C R Whitehouse
Journal: BMJ (1985)

Introducing a microcomputer into a general practice provides an opportunity to consider how different population groups use the services offered. In a study of the effect that distance has on consultation rates the results showed that patients who lived close to the surgery consulted a third more than those who lived over two and a half miles from the surgery. Further analysis showed that patients who might be expected to have transport difficulties were particularly low users.