tbuckley/cabot-search huggingface dataset:
Tetanus in injecting drug users
Authors: Nick J Beeching, Natasha S Crowcroft
Journal: BMJ (2005)

of laxatives, and overflow from faecal impaction-may present as incontinence with a normally functioning anal sphincter. 2 Even people with poor functioning of the sphincter can obtain much symptomatic benefit from measures to firm up the stool.If an underlying cause for diarrhoea is not found dietary advice can be very helpful, bearing in mind that a diet rich in fibre may exacerbate incontinence.Occasionally, antidiarrhoeals such as codeine phosphate or loperamide may be required.In a few patients these measures will be insufficient, and referral for testing of anorectal physiology and endo-anal ultrasonography becomes necessary.These investigations provide objective measures of sphincter pressures, anorectal sensation, rectal capacity, 7 and sphincter defects. 8A continence adviser can then help most patients by providing support and advice on diet, lifestyle, and pelvic floor exercise.Thereafter pelvic floor physiotherapy and biofeedback-in which patients are taught effective muscle contraction in response to information from a manometric or electromyographic rectal probes-are the mainstays of therapy. 9 In unresponsive patients with a noteworthy sphincter defect, surgical repair will produce a good outcome in 60-90% of patients, but unfortunately the results deteriorate with time. 10When surgical repair fails or is inappropriate and where biofeedback is ineffective three options remain for severely symptomatic patients-anal encirclement, sacral nerve stimulation, and diversion.Encirclement is achieved by means of muscle, and the dynamic graciloplasty, which involves a gracilis muscle wrap augmented by electrical stimulation, is perhaps the most successful.Another approach is the artificial sphincter, which consists of a fluid filled cuff implanted around the anal canal.However, these are specialised techniques which, although they can restore continence, often result in difficulty in passing stools and in morbidity. 2 Sacral nerve stimulation (or neuromodulation) is a relatively new technique for treating faecal incontinence and is used in patients with an intact or repaired sphincter complex. 11It involves placing a percutaneous electrode in a sacral foramen (usually S3), and if a two week test period is successful a permanent pulse generator can be implanted.Recent studies suggest that notable improvement can be achieved with little morbidity, and this procedure looks set to have a major impact. 12Despite these new treatments, the role of faecal diversion should not be ignored.If all else fails quality of life with a stoma can be excellent for the unfortunate patient with refractory incontinence.Although faecal incontinence is responsible for a great deal of misery and social isolation it lacks a high profile and vocal advocates.It is amenable to treatment that often can be delivered in primary care.Moreover, those unresponsive to simple measures should be given the opportunity for assessment by specialists and appropriate treatment.
Budget cuts may have led to E coli outbreak
Authors: D. Spurgeon
Journal: BMJ (2000)

Eleven people in the Canadian town of Walkerton, Ontario, have died from municipal drinking water contaminated by the O157:H7 strain of Escherichia coli, while about 1000 of the 5000 inhabitants have become ill.

Four different investigations—including a public inquiry announced by the provincial government—are under way to determine the cause of the pollution. It is believed that run-off containing animal wastes entered water conduits from nearby farms.

Critics are blaming funding cutbacks …
Analysis of quality of interventions in systematic reviews
Authors: Robert D Herbert, Kari B⊘
Journal: BMJ (2005)

The quality of interventions can affect the results of clinical trials.Reviews of complex interventions need to take this into account Complex health interventions, such as surgery or physiotherapy, can be administered well or badly.Variation in the quality of administration of interventions may explain some of the variability in estimates of effects between trials in systematic reviews.We argue that systematic reviews of complex interventions should assess the quality of interventions, and we suggest how to make such assessments.
Connell's Suture; A Question of Priority.
Authors: A. D. Davidson
Journal: JAMA (1900)

Troy, N. Y., Nov. 21, 1900. <h3>To the Editor:</h3> In November, 1896, I had the privilege of assisting Professor Thomas H. Manley, of New York, in a case of gangrenous strangulated hernia, necessitating a resection and lateral enterorrhaphy. The gangrenous loop measured 27 inches, and more than 3 inches of both free ends of gut were also excised, in all about 30 inches. In this instance the lateral enterorrhaphy was done by the "Connell" method, the patient making a prompt recovery. This was the first case of intestinal resection for gangrenous hernia by the "Connell suture" on record; but I am informed that the same surgeon again employed the same suture successfully in August last, after the excision of 19 inches of mortified intestine; here again uneventful recovery followed. I venture to intrude on your kindness in this matter, especially for two reasons: 1, to call attention to the "Connell,"
Report card assesses contribution to global health of leading US and Canadian universities
Authors: S. Bhaumik
Journal: BMJ (2013)

Some of the world’s top universities have been criticised for doing little to improve global health, despite the fact that many of them declare that as a goal. 

A new “report card” ranking universities by their contribution to global health has been produced by an international network of graduate and undergraduate students of medicine, research and law, called the Universities Allied for Essential Medicines.1

The group evaluated the efforts of 54 leading US and Canadian universities, by assigning grades to the universities on 14 key measures, broadly divided into three general categories of innovation, access, and empowerment. The group used data available in the public domain and supplemental information obtained from deans and directors of departments …
Inhibition of glucagon improves splanchnic hyporesponse to terlipressin in cirrhotic rats with blood retention in the gastric lumen
Authors: Ying-Ying Yang, Han-Chieh Lin, Yi-Tsau Huang, Ming-Chih Hou, Fa-Yauh Lee, Full-Young Chang, Shou-Dong Lee
Journal: Journal of Hepatology (2005)
Letter: Computers and privacy.
Authors: J F Sidebotham, G Ward, J H Bradshaw-Smith
Journal: BMJ (1976)

weakness in any other muscle groups.Two separate Tensilon tests (10 mg edrophonium chloride) wvith saline control were performed in a double-blind manner.After the first injection of edrophonium chloride the ptosis improved greatly, and two days later with the second test the im- provement was less marked.After the Tensilon tests all therapy was stopped and the patient referred to the late Professor Andrew Wilson, who suggested that this myasthenic syndrome might be related to the practolol.Electromyography revealed no abnormality, nor did it six months later, when the patient had been off all therapy.Investigations including ESR, haemoglobin, blood urea and electrolytes, thyroid function tests, and x-rays of the mediastinum revealed no abnormality.The myasthenic symptoms have not recurred following the second dose of edrophonium chloride, but because the patient's blood pressure rose after stopping the practolol he was restarted on spironolactone 100 mg daily and bendrofluazide 5 mg daily.
Oxygen-dependent ATF-4 stability is mediated by the PHD3 oxygen sensor
Authors: Jens Köditz, Jutta Nesper, Marieke Wottawa, Daniel P. Stiehl, Gieri Camenisch, Corinna Franke, Johanna Myllyharju, Roland H. Wenger, Dörthe M. Katschinski
Journal: Blood (2007)
Is democracy good for people's health? A South African perspective
Authors: Dan J Ncayiyana
Journal: BMJ (2004)

drivers were involved in crashes while smoking.In 1944, smoking was banned on trains and buses in cities.It was also prohibited in many workplaces, public buildings, hospitals, and rest homes.The advertising of smoking products was strictly controlled, and there was discussion on whether people with smoking related illnesses should receive medical care equal to that of patients with illnesses not seen to be self inflicted.Many leading Nazis-such as Robert Ley, leader of the German Labour Front, Hans Reiter, president of the Reich Health Office, and both Gerhard Wagner and Leonardo Conti, the successive Führers of German medicine-attested to the benefits of not smoking.Adolf Hitler was the star performer in antismoking propaganda.As one magazine stated, "Brother national socialist, do you know that your Führer is against smoking and thinks that every German is responsible to the whole people for all his deeds and missions, and does not have the right to damage his body with drugs?"Smoking was only one of the health related behaviours that received attention in Nazi Germany.The consumption of alcohol was also strongly campaigned against.Fruit and vegetable consumption was encouraged, as was the use of wholemeal bread and the avoidance of fat. 1 A key figure in Nazi medicine, Erwin Liek, predicted that cancer would come to be seen as a product of diet. 2 The consumption of whipped cream seems to have been a particular target of disapproval.The official newspaper of the SS, Das Schwarzes Korps, reported on German tourists in Austrian coffee houses and said that anyone would "think Greater Germany was only created so that this raving Philistine rabble can wolf whipped cream."A prominent promilitarist slogan read, "Fighting power or whipped cream?"Considerable interest was shown in the notion that a poor intrauterine environment would have long term deleterious effects on offspring.A 1942 health manual proclaimed "mothers, you must absolutely avoid alcohol and nicotine during pregnancy and when nursing.They hinder, they harm, they disrupt the normal course of pregnancy.Drink fruit juice."A public health
A Hot Spot of Genetic Instability in Autism
Authors: Evan E. Eichler, Andrew W. Zimmerman
Journal: New England Journal of Medicine (2008)

Sixty-five years after Leo Kanner first described autism,1 we are beginning to move beyond description of this clinically heterogeneous neurobehavioral syndrome toward a deeper understanding of its biologic complexity. In areas such as genetics and neuroscience, researchers have joined the search for objective measures to elucidate autism's pathogenesis.It has become clear that the solutions to autism will be neither simple nor uniform among patients with various autistic syndromes. At least 60 different genetic, metabolic, and neurologic disorders have been associated with autism and involve approximately 10% of patients, whose clinical presentations frequently vary, even among those with known disorders. . . .
AN UNUSUALLY LARGE GALLSTONE PASSED BY RECTUM
Authors: A. J. Gordon
Journal: JAMA (1924)

Large gallstones are often found at operation, but one seldom sees an exceedingly large stone passed by rectum. The stone shown in the accompanying illustration was passed by a woman, aged 58, who had had typical attacks of gallstone colic about nine years previously. When first seen the patient complained of a dull pain in the "pit of her stomach," also in the lower part of her chest posteriorly. The pain at times became quite severe, occasionally colicky in nature, but not radiating upward toward the shoulder on the right side as it did in the attacks nine years before. Constipation was also complained of. On physical examination it was noted that the skin was deeply jaundiced, as were the sclerae of the eyes. The gallbladder was easily palpable and tender to the touch, and slight rigidity was present in the gallbladder region. The patient's rectal temperature when I first
The Healer Within: The New Medicine of Mind and Body
Authors: Chase Patterson Kimball
Journal: JAMA (1986)

<i>The Healer Within</i>is a fast-paced book, enthusiastic, full of exclamation marks, a breezy overview. It attempts to cover the waterfront, with occasional depth. Thus, it is essentially superficial. It is difficult to identify the audience the authors anticipate. Is it addressed to the lay person? Could it inspire a high school student to become interested in the field of immunology? Will it lead the graduate physician and general practitioner to consider Selye's stress-resistance-exhaustion hypothesis as the psychosomatic paradigm for the development of organ system breakdown and disease? Yet, despite its superficial impression and the partially digested tidbits, the book is deceptive. It commands the reader's attention in an awe-inspiring way. It presents a straightforward didactic explanation of the research underlying the current preoccupation with immunologic concepts and the social-environmental situations that largely, albeit nonspecifically, result in disease factors. Paradigms of organ disease following the stress-resistance-exhaustion model emphasize the role
QUANTITATIVE STUDIES ON ANTIBODY PURIFICATION
Authors: Michael Heidelberger, Elvin A. Kabat
Journal: The Journal of Experimental Medicine (1938)

1. The salt dissociation and barium hydroxide-barium chloride methods are extended to the preparation of highly purified antibody solutions from specific precipitates derived from Type III and Type VIII antipneumococcus horse sera and a low grade polyvalent bovine serum. Analytically pure precipitin (agglutinin) was obtained from the last, and Types I, II, and III antibodies were separated. 2. Difficulties connected with the application of the methods to Type I antipneumococcus rabbit sera are described, as is also the purification of antibody from low grade pig and sheep sera. 3. The dissociation of antibody by both methods from Type I pneumococci agglutinated in antisera produced in the horse, rabbit, pig, and sheep, is described and its advantages discussed. 4. Certain theoretical aspects of the work are also discussed.
Treating normotensive hypertension
Authors: P Sidebotham
Journal: BMJ (1994)

I think that the physician was trying to convince me that there were problems with the hospital. Personally, I didn’t need convincing. I was only too aware of the inadequacies of this government hospital where I, as an aid worker, was trying to work alongside the government staff. Perhaps, though, I did need to learn a lesson about my Western approach to diagnosis and treatment.

He had invited me into his consulting room to see a few patients and had promptly disappeared, leaving me to run the clinic. The first patient I saw complained of “hypertension.” Through my translator …
Primary immunodeficiencies: 2009 update
Authors: Luigi D. Notarangelo, Alain Fischer, Raif S. Geha, Jean-Laurent Casanova, Helen Chapel, Mary Ellen Conley, Charlotte Cunningham-Rundles, Amos Etzioni, Lennart Hammartröm, Shigeaki Nonoyama, Hans D. Ochs, Jennifer Puck, Chaim Roifman, Reinhard Seger, Josiah Wedgwood
Journal: Journal of Allergy and Clinical Immunology (2009)
Psychodynamic Approach to the Most Common Psychiatric Disorders in the Elderly
Authors: George Spyros Philippopoulos
Journal: Psychotherapy and Psychosomatics (1979)

It should be emphasized that it was difficult for the author, if not impossible, to sort out any <i>specific</i> dynamic factor(s) or unconscious motive that could explain fully and appropriately the protean psychopathology of the patients seen and followed-up in his series. A multifactorial pathogenesis should be taken into consideration in such or similar cases. On the other hand, to make any attempt at an overall or generalized dynamic formulation in the elderly should, in the author's opinion, be out of the question.
Risk factors for Chlamydia trachomatis infection in adolescents: results from a representative population-based survey in Germany, 2003–2006
Authors: K Haar, V Bremer, C Houareau, T Meyer, S Desai, M Thamm, O Hamouda
Journal: Eurosurveillance (2013)

Binary file ES_Abstracts_Final_ECDC.txt matches
1228 EXPRESSION OF INFLAMMATORY AND ANGIOGENIC FACTORS IN SERUM OF PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE
Authors: S.H. Coulon, S. Francque, A. Geerts, A. Verrijken, B. Blomme, F. Heindryckx, H. Van Vlierberghe, L. Van Gaal, I. Colle
Journal: Journal of Hepatology (2012)
Choice in the NHS is limited to waiting times, BMA chief says
Authors: Rebecca Coombes
Journal: BMJ (2004)

The government is using “patient choice” as a means to drive down costs and introduce competition between the NHS and other care providers, the BMA told MPs this week.

James Johnson, chairman of the BMA Council, told the House of Commons Public Administration Select Committee that the government's claims to be giving patients more choice was in practice limited to a small area of policy: the reduction of waiting times for inpatients.

From December 2005 patients will be given a choice of hospitals for elective treatment, …
343 NO EVIDENCE FOR LOW-LEVEL HCV REPLICATION OR SIGNIFICANT LIVER FIBROSIS IN HIV PATIENTS WHO SPONTANEOUSLY CLEARED HCV INFECTION
Authors: P. Barreiro, E. Vispo, P. Tuma, P. Labarga, V. Rodriguez, J. Medrano, J.V. Fernandez, L. Martin-Carbonero, V. Soriano
Journal: Journal of Hepatology (2009)
Concepts of Medicine, A Collection of Essays on Aspects of Medicine
Authors: Marshall Brucer
Journal: JAMA (1962)

The history of medicine is full of statements that there are too many facts to know, too many fads to follow, too much literature to read. Much of what is printed is trivial, but how do you know it is trivial unless you are an expert in a particular small field? Much that is written is completely wrong, but how do you know before a hundred years have passed? There is a necessity for looking at the entire field of medical knowledge. Since the "field of medicine" includes all of science and much of art, the problem is magnified. There is a necessity for selection. The "... too readily accepted and unquestioned concept" needs to be questioned. There is a necessity for criticism, for contemplation on what concepts, rather than facts, to select. Since his student days, Dr. Brandon Lush has been clipping and saving essays and addresses that have interested
Use and Costs of Medical Care for Children and Adolescents With and Without Attention-Deficit/Hyperactivity Disorder
Authors: Cynthia L. Leibson
Journal: JAMA (2001)

A shortage of data exists on medical care use by persons with attention-deficit/hyperactivity disorder (ADHD).To compare medical care use and costs among persons with and without ADHD.Population-based cohort study conducted in Rochester, Minn.All children born in 1976-1982 were followed up through 1995, using school and medical records to identify those with ADHD. The 4880 birth cohort members (mean age, 7. 3 years) still residing in Rochester in 1987 were followed up in medical facility-linked billing databases until death, emigration, or December 31, 1995.Clinical diagnoses, likelihood and frequency of inpatient and outpatient hospitalizations, emergency department (ED) visits, and total medical costs (including ambulatory care), compared among individuals with and without ADHD.Among the 4119 birth cohort members who remained in the area through 1995 (mean age, 15.3 years), 7.5% (n = 309) had met criteria for ADHD. Compared with persons without ADHD, those with ADHD were more likely to have diagnoses in multiple categories, including major injuries (59% vs 49%; P<.001) and asthma (22% vs 13%; P<.001). The proportion with any hospital inpatient, hospital outpatient, or ED admission was higher for persons with ADHD vs those without ADHD (26% vs 18% [P<. 001], 41% vs 33% [P =.006], and 81% vs 74% [P =.005], respectively). The 9-year median costs for persons with ADHD compared with those without ADHD were more than double ($4306 vs $1944; P<.001), even for the subset with no hospital or ED admissions (eg, median 1987 costs, $128 vs $65; P<.001). The differences between individuals with and without ADHD were similar for males and females and across all age groups.In our cohort, compared with persons without ADHD, those with ADHD exhibited substantially greater use of medical care in multiple care delivery settings.
Polymorphisms in the IL-10 ligand and the IL-10 receptor β chain influence susceptibility to persistent HBV infection
Authors: M.R. Thursz, L. Zhang, A. Frodsham, U. Dumpis, M. Chiaramonte, C. Venturi-Pasini, S. Lobello, A.V. Hill, H.C. Thomas
Journal: Journal of Hepatology (2001)
Relation between Renal Dysfunction and Cardiovascular Outcomes after Myocardial Infarction
Authors: Nagesh S. Anavekar, John J.V. McMurray, Eric J. Velazquez, Scott D. Solomon, Lars Kober, Jean-Lucien Rouleau, Harvey D. White, Rolf Nordlander, Aldo Maggioni, Kenneth Dickstein, Steven Zelenkofske, Jeffrey D. Leimberger, Robert M. Califf, Marc A. Pfeffer
Journal: New England Journal of Medicine (2004)

The presence of coexisting conditions has a substantial effect on the outcome of acute myocardial infarction. Renal failure is associated with one of the highest risks, but the influence of milder degrees of renal impairment is less well defined.As part of the Valsartan in Acute Myocardial Infarction Trial (VALIANT), we identified 14,527 patients with acute myocardial infarction complicated by clinical or radiologic signs of heart failure, left ventricular dysfunction, or both, and a documented serum creatinine measurement. Patients were randomly assigned to receive captopril, valsartan, or both. The glomerular filtration rate (GFR) was estimated by means of the four-component Modification of Diet in Renal Disease equation, and the patients were grouped according to their estimated GFR. We used a 70-candidate variable model to adjust and compare overall mortality and composite cardiovascular events among four GFR groups.The distribution of estimated GFR was wide and normally shaped, with a mean (+/-SD) value of 70+/-21 ml per minute per 1.73 m2 of body-surface area. The prevalence of coexisting risk factors, prior cardiovascular disease, and a Killip class of more than I was greatest among patients with a reduced estimated GFR (less than 45.0 ml per minute per 1.73 m2), and the use of aspirin, beta-blockers, statins, or coronary-revascularization procedures was lowest in this group. The risk of death or the composite end point of death from cardiovascular causes, reinfarction, congestive heart failure, stroke, or resuscitation after cardiac arrest increased with declining estimated GFRs. Although the rate of renal events increased with declining estimated GFRs, the adverse outcomes were predominantly cardiovascular. Below 81.0 ml per minute per 1.73 m2, each reduction of the estimated GFR by 10 units was associated with a hazard ratio for death and nonfatal cardiovascular outcomes of 1.10 (95 percent confidence interval, 1.08 to 1.12), which was independent of the treatment assignment.Even mild renal disease, as assessed by the estimated GFR, should be considered a major risk factor for cardiovascular complications after a myocardial infarction.
Prediction of Heart Failure — An Art Aided by Technology
Authors: Philip A. Poole-Wilson
Journal: New England Journal of Medicine (1997)

Heart failure is common, has a poor prognosis,1 and can be treated.2 The incidence is increasing, partly because of improved survival after myocardial infarction and partly because the population is aging and heart failure is a disease of the elderly. The most common causes are coronary heart disease and hypertension, and the prevention of heart failure is inextricably linked to the prevention of these disorders. An enlarged heart, a known precursor of heart failure, is often detectable before the onset of symptoms, and early treatment slows the progression to overt heart failure.3 Patients included in recent trials of new treatments . . .