tbuckley/cabot-search huggingface dataset:
Evidence based medicine: does it make a difference?
Authors: Yoav Ben-Shlomo
Journal: BMJ (2005)

Evidence based medicine: does it make a difference? Use wiselyEditor-The term "evidence based medicine" entered the scientific lexicon only a little more than a decade ago. 1 What caused its remarkable spread, and what are the implications of its broad and rapid diffusion?The team that coined the term at first considered using the phrase "scientific medicine" but rejected it because it implied that other approaches were by definition unscientific. 2However, critics have argued that the term evidence based medicine carries a similar moral valence and linguistic slipperiness. 3 Who could argue against the notion of providing care that integrates individual clinical skill and the best external evidence? 4 Originally developed as a method for teaching medical residents, evidence based medicine is being applied ever more broadly to the organisation and delivery of medical services.Multiple stakeholders now seek to assume its mantle for purposes that often contradict its original intent.Managers, equating lack of evidence with lack of effectiveness, use it as a rationale for cutting services.Industry generates evidence of questionable quality to promote its products.Medical researchers come to believe that they hold a monopoly on generating and interpreting evidence.Evidence based medicine, developed as a means of taming the unscientific and messy world of clinical practice, has itself entered the unscientific and messy world of politics. 5ike any technology, evidence based medicine carries risks and benefits and can be used appropriately or inappropriately.Overly inclusive definitions threaten to deprive the term of meaning, and unchecked use increases the risk of misuse.In the past decade, evidence based medicine has contributed much to how we teach, deliver, and think about clinical services.In the coming decade, we must continue to ensure that it is not only used widely but wisely.
The Investigation of an Unusual Asphyxial Death in a Hospital
Authors: Kris Sperry
Journal: JAMA (1986)

ADVANCES in the technology of life support and maintenance during the past several decades have been responsible for the saving of countless lives. A critically ill patient may be surrounded by an overwhelming mass of tubes, wires, and stateof-the-art appurtenances. When a patient's condition deteriorates, life-assist devices and monitors proliferate as all available devices of advanced medical technology are brought to bear in an effort to maintain a life. With the burgeoning of complex equipment there has been an accompanying rise in the number of deaths due to machine malfunction and as complications of long-term indwelling intravascular devices. The potential fatal complications of hemodialysis<sup>1</sup>and Swan-Ganz catheters<sup>2</sup>are particularly well known. Investigation of deaths in such patients requires close scrutiny of all human and mechanical involvement, and an organized, sequential approach to investigation and postmortem examination is optimal.<sup>3</sup>The investigation of iatrogenic deaths related to medical equipment
Pattern of HCV antibodies with special reference to NS5A reactivity in HCV-infected patients: relation to viral genotype, cryoglobulinemia and response to interferon
Authors: Lionel Frangeul, Pascale Cresta, Michele Perrin, Gilles Duverlie, Hafida Khorsi, Lucile Musset, Pierre Opolon, Jean-Marie Huraux, Françoise Lunel
Journal: Journal of Hepatology (1998)
Eye injuries in racquet sports.
Authors: C J MacEwen, N P Jones
Journal: BMJ (1991)

may be difficult as most women exposed to stilboestrol show some atypical features.'0Consequently, unless the colposcopist is familiar with the problems of exposure there is a tendency to overtreat these women.Caution is recommended in applying locally destructive measures for cervical intra- epithelial neoplasia as up to three quarters of affected women will develop cervical stenosis.27Most women require annual colposcopy, with more frequent examination required in the presence of dysplastic change.No studies have been published concerning contraception in women exposed to stilboestrol.Lacking definite data, some physicians prefer not to prescribe hormonal contraceptives,28 and as these women are already at risk of an impaired outcome of pregnancy avoiding using intrauterine contraceptive devices seems prudent.In Britain stilboestrol was probably last prescribed in pregnancy in 1973.How relevant is this topic today?Many of those who were exposed in utero are now aged between 20 and 35.They have reached the reproductive phase of their lives and also the time when they are at most risk of cervical intraepithelial neoplasia.Whether in utero exposure to stilboestrol has any consequences for women entering the menopause and postmenopausal years is not yet known.More generally, the stilboestrol story has important implications for clinical pharmacology and, in particular, for the use of drugs in pregnancy.It shows, if any further demonstration were needed, the absolute necessity for properly performed clinical trials-assessing both efficacy and long term side effects-before the introduction of any new treatment.
The Importance of the Muscle and Ventilatory Blood Pumps During Exercise in Patients Without a Subpulmonary Ventricle (Fontan Operation)
Authors: Keri M. Shafer, Jorge A. Garcia, Tony G. Babb, David E. Fixler, Colby R. Ayers, Benjamin D. Levine
Journal: Journal of the American College of Cardiology (2012)
Jaundice
Authors: Lawrence D. Wruble
Journal: JAMA (1966)

The clinical efficacy of a short course of steroid therapy in differentiating the etiology of jaundice was determined. Also, observations were made on the mechanism of action of steroids on bilirubin metabolism. A standard five-day course of prednisone, 60 mg daily, was given to 33 patients. The final diagnosis was established by biopsy, laparotomy, or autopsy. Clinically, the response to this course of steroids clearly separated extrahepatic jaundice due to malignancy from intrahepatic jaundice of viral inflammatory origin. In viral hepatitis, the suggested mechanism of action of steroids appears to be enhanced clearing of conjugated bilirubin from the serum.
Meckel's Diverticulum In a Premature Infant
Authors: Homayoon Ganji
Journal: JAMA (1967)

<h3>To the Editor:—</h3> Since Meckel's description of the congenital diverticulum of the small intestine in 1809,<sup>1</sup>the medical literature discussing this anomaly has increased steadily. We report the case of a 36-hour-old premature infant with a giant Meckel's diverticulum visualized as a gas shadow on the roentgenogram of the abdomen. <h3>Report of A Case:—</h3> This 1,830-gm premature male infant was born spontaneously (breech presentation) to a gravida 2, para 1, 33-year-old Negro mother on Dec 10, 1965, at Charity Hospital, New Orleans. The date of the mother's last menstrual period was unknown. Serologic tests for syphilis performed on blood obtained at delivery showed a positive VDRL slide test at one dilution and a weakly positive Kolmer's test. The amniotic sac leaked for approximately 24 hours prior to delivery. After birth, the Apgar score was 6 at one minute and 8 at five minutes. On admission to the Premature Center, this
Gavin Brown Shaw
Authors: Tom Drysdale
Journal: BMJ (2008)

Dr Gavin Shaw, who undertook pioneering work in developing the use of cardiac pacemakers and in cardiac resuscitation and who played a prominent part in the development of medical services and postgraduate medical education in the greater Glasgow area, has died at the age of 88. He was a past president of the Royal College of Physicians and Surgeons of Glasgow and was influential in developing its status as a leading postgraduate educational institute.

Gavin Brown Shaw was born and brought up in Uddingston, near Glasgow. He attended Glasgow Academy and Glasgow University, graduating BSc in 1939 and MB ChB in 1942. During his time at the university he served as secretary, and later president, of the students’ representative council.

In 1942 he was appointed house physician to Sir John McNee at the Western Infirmary in Glasgow. McNee was the first clinical professor to be employed in Glasgow on a full time basis, as part of a deliberate policy of reforming the university medical school along modern lines and of raising its academic standards.

In 1943 Gavin was commissioned as a …
Measurement of dermal atrophy induced by topical steroids using a radiographic technique
Authors: M.P. JAMES, M.M. BLACK, C.G. SPARKES
Journal: British Journal of Dermatology (1977)

Journal Article Measurement of dermal atrophy induced by topical steroids using a radiographic technique Get access M.P. JAMES, M.P. JAMES Department of Dermatology, St Thomas' Hospital, London SEI 7EH Search for other works by this author on: Oxford Academic Google Scholar M.M. BLACK, M.M. BLACK Department of Dermatology, St Thomas' Hospital, London SEI 7EH Search for other works by this author on: Oxford Academic Google Scholar C.G. SPARKES C.G. SPARKES Glaxo Laboratories Ltd, Greenford, Middlesex UB6 oHE Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 96, Issue 3, 1 March 1977, Pages 303–306, https://doi.org/10.1111/j.1365-2133.1977.tb06142.x Published: 01 March 1977
Clinical and Genetic Heterogeneity of Latent Autoimmune Diabetes in Adults
Authors: Nóra Hosszúfalusi, Pál Pánczél
Journal: Diabetes Care (2003)

We read with interest the comments of Fukui et al. (1) in this issue of Diabetes Care regarding our recent article (2). They claim that patients with latent autoimmune diabetes in adults (LADA) are heterogeneous in their clinical attributes and that the LADA patients in our study represented the LADA type 1 subgroup. Because of this, we observed that their clinical and genetic characteristics resembled patients having rapidly progressive adult-onset type 1 diabetes. We agree that LADA patients may show heterogeneous clinical features, but we feel that our patients with LADA are representative of the whole LADA group: 25% of our LADA patients belonged to the overweight category based on their BMI, and the same percentage of patients had lipid abnormalities. The median of the insulin-free period after the diagnosis of diabetes was 3.0 years (1.0–6.0), despite the fact that we initiated insulin therapy in 23 of our …
Non-medical treatment of GORD
Authors: D Munzer
Journal: Gut (2003)

The interesting comment of Heading ( Gut 2002; 50 :592–3) on the work by Fibbe et al needs to be completed by considering the anatomical factor in the study of gastro-oesophageal reflux disease (GORD) before advocating any non-medical appropriate treatment (fundoplicator, Stratten procedure, Gastropexie, etc).

The …
Significance of Milk pH in Newborn Infants
Authors: V. C. Harrison, G. Peat
Journal: BMJ (1972)

Bottle-fed infants do not gain weight as rapidly as breast-fed babies during the first week of life. This weight lag can be corrected by the addition of a small amount of alkali (sodium bicarbonate or trometamol) to the feeds. The alkali corrects the acidity of cow9s milk which now assumes some of the properties of human breast milk. It has a bacteriostatic effect on specific <i>Escherichia coli</i> in vitro, and in infants it produces a stool with a preponderance of lactobacilli over <i>E. coli</i> organisms. When alkali is removed from the milk there is a decrease in the weight of an infant and the stools contain excessive numbers of <i>E. coli</i> bacteria. A pH-corrected milk appears to be more physiological than unaltered cow9s milk and may provide some protection against gastroenteritis in early life. Its bacteriostatic effect on specific <i>E. coli</i> may be of practical significance in feed preparations where terminal sterilization and refrigeration are not available. The study was conducted during the week after birth, and no conclusions are derived for older infants. The long-term effects of trometamol are unknown. No recommendation can be given for the addition of sodium bicarbonate to milks containing a higher content of sodium.
Abnormalities of sexual development in male rats with in utero and lactational exposure to the antiandrogenic plasticizer Di(2-ethylhexyl) phthalate.
Authors: R W Moore, T A Rudy, T M Lin, K Ko, R E Peterson
Journal: Environmental Health Perspectives (2001)

Several members of the phthalate ester family have antiandrogenic properties, yet little is known about how exposure to these ubiquitous environmental contaminants early in development may affect sexual development. We conducted experiments to determine effects of in utero and lactational exposure to the most prevalent phthalate ester, di(2-ethylhexyl) phthalate (DEHP), on male reproductive system development and sexual behavior. Sprague-Dawley rats were dosed with corn oil or DEHP (0, 375, 750, or 1,500 mg/kg/day, per os) from gestation day 3 through postnatal day (PND) 21. Dose-related effects on male offspring included reduced anogenital distance, areola and nipple retention, undescended testes, and permanently incomplete preputial separation. Testis, epididymis, glans penis, ventral prostate, dorsolateral prostate, anterior prostate, and seminal vesicle weights were reduced at PND 21, 63, and/or 105-112. Additional dose-related effects included a high incidence of anterior prostate agenesis, a lower incidence of partial or complete ventral prostate agenesis, occasional dorsolateral prostate and seminal vesicle agenesis, reduced sperm counts, and testicular, epididymal, and penile malformations. Many DEHP-exposed males were sexually inactive in the presence of receptive control females, but sexual inactivity did not correlate with abnormal male reproductive organs. These results suggest that in utero and lactational DEHP exposure also inhibited sexually dimorphic central nervous system development. No major abnormalities were found in any of eight control litters, but DEHP caused severe male reproductive system toxicity in five of eight litters at 375 mg/kg/day, seven of eight litters at 750 mg/kg/day, and five of five litters at 1,500 mg/kg/day. These results demonstrate that the male reproductive system is far more sensitive to DEHP early in development than when animals are exposed as juveniles or adults. The effects of DEHP on male reproductive organs and sexual behaviors and the lack of significant effects on time to vaginal opening and first estrus in their littermates demonstrate that DEHP (and/or its metabolites) affects development of the male reproductive system primarily by acting as an antiandrogen. The pattern of effects of in utero and lactational DEHP exposure differed from patterns caused by other phthalate esters, and the preponderance of anterior prostate agenesis appears to be unique among all chemicals. These results suggest that DEHP acts partly by mechanisms distinct from those of other antiandrogens.
Genetic Variation in Base Excision Repair Pathway Genes, Pesticide Exposure, and Prostate Cancer Risk
Authors: Kathryn Hughes Barry, Stella Koutros, Sonja I. Berndt, Gabriella Andreotti, Jane A. Hoppin, Dale P. Sandler, Laurie A. Burdette, Meredith Yeager, Laura E. Beane Freeman, Jay H. Lubin, Xiaomei Ma, Tongzhang Zheng, Michael C.R. Alavanja
Journal: Environmental Health Perspectives (2011)

Previous research indicates increased prostate cancer risk for pesticide applicators and pesticide manufacturing workers. Although underlying mechanisms are unknown, evidence suggests a role of oxidative DNA damage.Because base excision repair (BER) is the predominant pathway involved in repairing oxidative damage, we evaluated interactions between 39 pesticides and 394 tag single-nucleotide polymorphisms (SNPs) for 31 BER genes among 776 prostate cancer cases and 1,444 male controls in a nested case-control study of white Agricultural Health Study (AHS) pesticide applicators.We used likelihood ratio tests from logistic regression models to determine p-values for interactions between three-level pesticide exposure variables (none/low/high) and SNPs (assuming a dominant model), and the false discovery rate (FDR) multiple comparison adjustment approach.The interaction between fonofos and rs1983132 in NEIL3 [nei endonuclease VIII-like 3 (Escherichia coli)], which encodes a glycosylase that can initiate BER, was the most significant overall [interaction p-value (pinteract) = 9.3 × 10-6; FDR-adjusted p-value = 0.01]. Fonofos exposure was associated with a monotonic increase in prostate cancer risk among men with CT/TT genotypes for rs1983132 [odds ratios (95% confidence intervals) for low and high use compared with no use were 1.65 (0.91, 3.01) and 3.25 (1.78, 5.92), respectively], whereas fonofos was not associated with prostate cancer risk among men with the CC genotype. Carbofuran and S-ethyl dipropylthiocarbamate (EPTC) interacted similarly with rs1983132; however, these interactions did not meet an FDR < 0.2.Our significant finding regarding fonofos is consistent with previous AHS findings of increased prostate cancer risk with fonofos exposure among those with a family history of prostate cancer. Although requiring replication, our findings suggest a role of BER genetic variation in pesticide-associated prostate cancer risk.
Recombinant Human Growth Hormone, Insulin-like Growth Factor 1, and Combination Therapy in AIDS-Associated Wasting
Authors: Debra Waters
Journal: Annals of Internal Medicine (1996)

Objective: To increase lean body mass and improve health status in patients with wasting associated with the acquired immunodeficiency syndrome (AIDS) by treatment with recombinant human growth hormone (rhGH), recombinant human insulin-like growth factor 1 (rhIGF-1), or both. Design: Randomized, double-blind, placebo-controlled clinical trial. Setting: University of New Mexico Clinical Research Center and University of Texas Southwestern Medical Center. Patients: 60 patients with AIDS and wasting as defined by the Centers for Disease Control and Prevention. Patients were divided into four groups of 15 patients each. Intervention: Group 1 received 1.4 mg of rhGH once daily plus placebo twice daily; group 2 received 5 mg of rhIGF-1 twice daily plus placebo once daily; group 3 received 5 mg of rhIGF-1 twice daily plus 1.4 mg of rhGH once daily; and group 4 received placebo three times daily. Measurements: Body weight, body composition, muscle strength, protein catabolism, quality of life, and immune status were assessed at baseline, and changes in these variables were measured at 6 and 12 weeks. Results: At 6 weeks, lean body mass had increased and total fat mass had decreased in the groups receiving rhGH, rhIGF-1, or both. Group 3 had the greatest changes in lean body mass (mean ± SE, 3.2 ± 0.59 kg; P < 0.001); only in this group were changes in body mass maintained at 12 weeks. Only patients in group 1 had improvement in muscular strength of the knees and upper body (P = 0.04) and quality of life (P = 0.01). Immunologic function did not improve in any group. Conclusions: Growth factor therapy had significantly increased lean body mass and decreased fat mass by 6 weeks, but these improvements persisted for 12 weeks only in group 3. Growth factor therapy at the dosages used in this study is not recommended because the magnitude of weight gain was modest and improvements in quality-of-life measures varied. Deceased.
The eosinophil granulocyte in psoriasis
Authors: A. LUNDIN, K. FREDENS, G. MICHAELSSON, P. VENGE
Journal: British Journal of Dermatology (1990)

Journal Article The eosinophil granulocyte in psoriasis Get access Å. LUNDIN, Å. LUNDIN Departments of Dermatology University of Aarhus, Denmark Dr Å.Lundin, Department of Dermatology, University Hospital, S‐751 85 Uppsala, Sweden. Search for other works by this author on: Oxford Academic Google Scholar K. FREDENS, K. FREDENS Institute of Neurobiology, University of Aarhus, Denmark Search for other works by this author on: Oxford Academic Google Scholar G. MICHAËLSSON, G. MICHAËLSSON Departments of Dermatology University of Aarhus, Denmark Search for other works by this author on: Oxford Academic Google Scholar P. VENGE P. VENGE Departments of Clinical Chemistry, University Hospital, Uppsala, Sweden Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 122, Issue 2, 1 February 1990, Pages 181–193, https://doi.org/10.1111/j.1365-2133.1990.tb08264.x Published: 01 February 1990
Expression of high Km 5′-nucleotidase in leukemic blasts is an independent prognostic factor in adults with acute myeloid leukemia
Authors: Carlos M. Galmarini, Kathryn Graham, Xavier Thomas, Fabien Calvo, Philippe Rousselot, Assia El Jafaari, Emeline Cros, John R. Mackey, Charles Dumontet
Journal: Blood (2001)
The role of adhesion molecules in the recruitment of hepatic natural killer cells (pit cells) in rat liver
Authors: D Luo, K Vanderkerken, L Bouwens, P J Kuppen, M Baekeland, C Seynaeve, E Wisse
Journal: Hepatology (1996)

Previous studies showed that blood large granular lymphocytes (LGL), which possess natural killer (NK) activity, develop within rat liver sinusoids into high–density (HD) and subsequently into low–density (LD) pit cells which show an increasing level and spectrum of tumor cytotoxicity. In this study, we investigated the role of adhesion molecules, such as CD2, CD11a, CD18, and CD54 in the recruitment of pit cells to the liver. Immunostaining for electron microscopy, and two color flow cytometry showed that most pit cells expressed CD2, CD11a, CD18, and CD54. After intravenous injections into rats with anti–CD2, anti–CD11a, and anti–CD18 antibodies, the number of pit cells per square millimeter in frozen sections of liver tissue decreased. Treatment of rats with zymosan increased the number of pit cells fivefold, whereas subsequent treatment with anti–adhesion–molecule antibodies resulted in approximately 60% lower number of pit cells. Anti–CD54, supposed to block CD54 expression on sinusoidal endothelial cells, also decreased the number of pit cells. The number of blood LGL was, however, not affected by these antibodies. These results indicate that blocking of CD2, CD11a, CD18, and CD54 antigens on blood LGL and/or liver endothelium decreased the number of pit cells in the liver. These adhesion molecules therefore play an important role in the recruitment of pit cells in the liver.