tbuckley/cabot-search huggingface dataset:
Small, not large, teams assess hospitals internationally
Authors: C. D. Shaw
Journal: BMJ (2013)

In his letter, Auger argues that the new Care Quality Commission inspection regime is under-resourced.1 Apart from their demands on clinical specialist time, and competing with peer review by the royal colleges and associations, inspection teams of 20-25 may be unsustainable. They may have worked better for the pinpoint investigation of the Keogh reviews of 14 hospitals than they would for programmed review of …
Myopathy Associated with Chronic Colchicine Toxicity
Authors: Hermes A. Kontos
Journal: New England Journal of Medicine (1962)

TOXIC manifestations from the use of colchicine in the treatment or prevention of attacks of acute gouty arthritis, apart from the well known gastrointestinal effects of the drug, are rare. The administration of 2.3 to 4.0 mg. of colchicine daily for a few days to patients with inoperable malignant tumors produced gastrointestinal disturbances, depilation, bone-marrow depression and peripheral neuritis.1 In 1 case the ingestion of 15 mg., for suicidal purposes,2 caused neurologic manifestations similar to those observed in acute animal toxicity experiments.3 In the case presented below the repeated ingestion of toxic doses of colchicine was followed by the development . . .
A change of culture, but how?
Authors: F. Godlee
Journal: BMJ (2013)

Iona Heath writes her last column for us this week (doi:10.1136/bmj.f1004). Over the past seven years, her six weekly observations have acted as an external conscience for the BMJ . Her eloquence on the need to fight for social justice, personal integrity, and ethical practice has reminded us that we are not, and should never be, neutral on such matters. Readers have told us how her column sparks corridor debates. Her words have refreshed their sense of what it means to be a doctor working for the public good.

It is fitting, and perhaps not surprising, that her last column is a …
Factor VIII complex in uraemia and effects of haemodialysis.
Authors: J H Turney, H F Woods, M R Fewell, M J Weston
Journal: BMJ (1981)

Levels of the factor VIII complex were found to be raised in patients with chronic renal failure and further raised by regular dialysis. Increased fibrinogen concentrations were also found. These results suggest the existence of a prothrombotic state in uraemia that is exacerbated by haemodialysis. Ristocetin-induced platelet agglutination, however, was depressed in uraemia and worsened by dialysis. This defect may be transferred to normal platelets from dialysed uraemic plasma, suggesting the existence of an inhibitor of the interaction between factor VIII and platelet glycoprotein. These results may help to explain the anomaly of a prolonged bleeding time together with accelerated atherogenesis that is found in patients with uraemia receiving dialysis.
Long-term protection of chimpanzees against high-dose HIV-1 challenge induced by immunization
Authors: Michael D. Lubeck, Robert Natuk, Maria Myagkikh, Narender Kalyan, Kristine Aldrich, Faruk Sinangil, Shabnam Alipanah, Shri C.S. Murthy, Pranab K. Chanda, Stephen M. Nigida, Phillip D. Markham, Susan Zolla-pazner, Kathy Steimer, Mark Wade, Marvin S. Reitz, Larry O. Arthur, Satoshi Mizutani, Alan Davis, Paul P. Hung, Robert C. Gallo, Jorg Eichberg, Marjorie Robert-Guroff
Journal: Nature Medicine (1997)
A hypomorphic recombination-activating gene 1 (RAG1) mutation resulting in a phenotype resembling common variable immunodeficiency
Authors: Hassan Abolhassani, Ning Wang, Asghar Aghamohammadi, Nima Rezaei, Yu Nee Lee, Francesco Frugoni, Luigi D. Notarangelo, Qiang Pan-Hammarström, Lennart Hammarström
Journal: Journal of Allergy and Clinical Immunology (2014)
Magnetic Resonance Imaging of Mesenchymal Stem Cells Homing to Pulmonary Metastases Using Biocompatible Magnetic Nanoparticles
Authors: Michael R. Loebinger, Panagiotis G. Kyrtatos, Mark Turmaine, Anthony N. Price, Quentin Pankhurst, Mark F. Lythgoe, Sam M. Janes
Journal: Cancer Research (2009)

Abstract The ability of mesenchymal stem cells (MSC) to specifically home to tumors has suggested their potential use as a delivery vehicle for cancer therapeutics. MSC integration into tumors has been shown in animal models using histopathologic techniques after animal sacrifice. Tracking the delivery and engraftment of MSCs into human tumors will need in vivo imaging techniques. We hypothesized that labeling MSCs with iron oxide nanoparticles would enable in vivo tracking with magnetic resonance imaging (MRI). Human MSCs were labeled in vitro with superparamagnetic iron oxide nanoparticles, with no effect on differentiation potential, proliferation, survival, or migration of the cells. In initial experiments, we showed that as few as 1,000 MSCs carrying iron oxide nanoparticles can be detected by MRI one month after their coinjection with breast cancer cells that formed subcutaneous tumors. Subsequently, we show that i.v.- injected iron-labeled MSCs could be tracked in vivo to multiple lung metastases using MRI, observations that were confirmed histologically. This is the first study to use MRI to track MSCs to lung metastases in vivo. This technique has the potential to show MSC integration into human tumors, allowing early-phase clinical studies examining MSC homing in patients with metastatic tumors. [Cancer Res 2009;69(23):8862–7]
A STUDY OF SIR JAMES PAGET IN HIS WRITINGS.
Authors: HELEN C. PUTNAM
Journal: JAMA (1903)

"Examine men's ruling principles, even those of the wise, what kind of things they avoid, and what kind they pursue."—Antoninus. By chance I was searching English medical journals for a special item two years ago, at the time they were containing obituaries of Sir James Paget. My attention was held by the ring of personal affection and esteem in practically every mention. Their essence seemed to be: He was a great surgeon and pathologist, an ideal teacher and lecturer, and the best loved of his profession in Great Britain. Any one of these records in the book of fame would satisfy a large majority; and the wish arose to learn more of their combination in a single individual. The question came to mind: How far may the personality of a scientific man be revealed by his writings?—"the subtlest form." Phillips Brooks has said,
Prognostic value of procalcitonin in community-acquired pneumonia
Authors: P. Schuetz, I. Suter-Widmer, A. Chaudri, M. Christ-Crain, W. Zimmerli, B. Mueller
Journal: European Respiratory Journal (2010)

The prognostic value of procalcitonin (PCT) levels to predict mortality and other adverse events in community-acquired pneumonia (CAP) remains undefined. We assessed the performance of PCT overall, stratified into four predefined procalcitonin tiers (< 0.1, 0.1-0.25, > 0.25-0.5, >0.5 μg·L⁻¹) and stratified by Pneumonia Severity Index (PSI) and CURB-65 (confusion, urea >7 mmol·L⁻¹, respiratory frequency ≥ 30 breaths·min⁻¹, systolic blood pressure < 90 mmHg or diastolic blood pressure ≤ 60 mmHg, and age ≥ 65 yrs) risk classes to predict all-cause mortality and adverse events within 30 days follow-up in 925 CAP patients. In receiver operating characteristic curves, initial PCT levels performed only moderately for mortality prediction (area under the curve (AUC) 0.60) and did not improve clinical risk scores. Follow-up measurements on days 3, 5 and 7 showed better prognostic performance (AUCs 0.61, 0.68 and 0.73). For prediction of adverse events, the AUC was 0.66 and PCT significantly improved the PSI (from 0.67 to 0.71) and the CURB-65 (from 0.64 to 0.70). In Kaplan-Meier curves, PCT tiers significantly separated patients within PSI and CURB-65 risk classes for adverse events prediction, but not for mortality. Reclassification analysis confirmed the added value of PCT for adverse event prediction, but not mortality. Initial PCT levels provide only moderate prognostic information concerning mortality risk and did not improve clinical risk scores. However, PCT was helpful during follow-up and for prediction of adverse events and, thereby, improved the PSI and CURB65 scores.
How useful a diagnosis is borderline personality disorder?
Authors: D R Davis
Journal: BMJ (1987)

mothers with high concentrations of thyroid stimulating immunoglobulins who may yet be hypothyroid and receiving thyroxine after previous treatment, especially surgery, to ablate the thyroid.Diagnosis of fetal thyrotoxicosis is difficult but may be suspected from fetal tachyarrhythmias if the mother has appreciable extrathyroidal features of Graves' disease or high concentrations of thyroid stimulating hormone binding antibodies.Treatment with both carbimazole and propranolol has been successful, although neonatologists do not like propranolol.'5Maternal thyroid state after giving birth has been intensively studied in Japan.Thyrotoxicosis often relapses,'6 but after a few months there may then be a clinically important period of hypothyroidism, which is followed by yet another bout of enhanced thyroid function six to nine months after delivery."These mysterious but important changes illustrate the powerful and long lasting but ill.understood mayhem that pregnancy causes in the immune system.
Rationing and the Americans With Disabilities Act
Authors: Loretta M. Kopelman
Journal: JAMA (1994)

<h3>To the Editor.</h3> —In a comprehensive and insightful discussion of the possible impact of the Americans With Disabilities Act (ADA) on health care rationing of beneficial treatments,<sup>1</sup>Dr Orentlicher recommends some moral guidelines for ADA's interpretation to balance people's competing needs: "If rationing decisions will disproportionately affect persons with disabilities, the decisions need to be justified by legitimate nondiscriminatory reasons. Ethically relevant criteria include (1) likelihood of benefit, (2) duration of benefit, (3) degree of benefit, (4) cost, and (5) number of people who will benefit. It would not be appropriate to consider ethically irrelevant criteria like social worth."<sup>1(p312)</sup> The solution, however, presupposes social agreement about, first, what counts as a benefit and, second, how to access and compare degrees of benefit in themselves and in relation to their costs. Unfortunately, a series of court cases show we as a society do not agree. In the cases of
Remarks on 'Kidinga Pepo': A Peculiar Form of Exanthematous Disease
Authors: J. Christie
Journal: BMJ (1872)

EARLY in the month ofTulyI87o, after the complete disappearance of cholera from the island of Zanzibar, a new form of fever, quite unknown to the bulk of the population, became epidemic, more especially in the town, where it attacked almost the entire population.The natives of India resident here were entirely unacquainted with it in their native country, and they named it" homa maguu", or leg-fever, from one of its most prominent symptoms-viz., severe pains in the lower extremi- ties.The Arabs from Oman and the Persian Gulf confounded it with " bardiabis", or rheumatisml, but still acknowledged that many of the symptoms were heretofore unknown to them; and the Arabs from Ilydramaut, in the Gulf of Arabia, spoke of it as a disease with which they were well acquainted in their native country, and they named it " ndefu", a word to which no very distinct meaning in Arabic can be attached.Thiswvord was speedily changed by the Suaheli of Zanzibar into the familiar word "madifu", meaning " beards"; but the name was used only by the slave population.The natives of the mainland seem to have been entirely unacquainted with the disease, as no native term was applied to it.Those inhabitants of Zanzibar who were pretty well advanced in life at once recognised it as a disease which was epi- demic on the east coast of Africa about forty-eight years ago, and which was then called " kidinga pepo".In regard to this, all the old inhabitants, whether Suaheli, Hindees, or Arabs, agreed; and their nomenclature, "kidinga pepo", was at once adopted as the proper name of the disease.The word " pepo" was soon changed into "popo", which made its significance much more obscure, or even absurd-as " pepo" means an evil spirit, and " popo" a butterfly or a bat.The word "kidinga" is now obsolete in general conversation in Zanzibar, but in signification it is nearly allied to that of" ganzi" or cramp.Mlany diseases are supposed by the Suaheli and
Personality Traits and Metabolic Control: A Study in Insulin-Dependent Diabetes mellitus Patients
Authors: Alvise Orlandini, Matteo Rocco Pastore, Andrea Fossati, Stefano Clerici, Alessandro Sergi, Annalisa Balini, Cesare Maffei, Antonio Secchi, Guido Pozza
Journal: Psychotherapy and Psychosomatics (1997)

In the present study the authors evaluated the relationship between personality traits (according to DSM-III-R) and poor metabolic control in an adult onset insulin-dependent diabetes mellitus sample (n = 77).Personality traits were assessed with the Personality Diagnostic Questionnaire--Revised. Metabolic control was evaluated through glycosilated hemoglobin (HbA1c): poor metabolic control was defined as HbA1c > or = 9% (normal values < 6.0%).Principal Component Analysis revealed three personality profiles: 'Cluster A/C Mixed', 'Cluster B Dependent' and 'Cluster B Aggressive'. Oneway ANCOVA, using sex as covariate, revealed a significant association (p = 0.01) only between poor metabolic control and Cluster B Dependent profile. No correlation was found between HbA1c and the other profiles.These data suggest that a specific personality profile is associated with poor metabolic control.
Endothelial Progenitor Cells and a Stromal Cell–derived Factor-1α Analogue Synergistically Improve Survival in Sepsis
Authors: Hongkuan Fan, Andrew J. Goodwin, Eugene Chang, Basilia Zingarelli, Keith Borg, Shuwen Guan, Perry V. Halushka, James A. Cook
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Endothelial progenitor cells (EPCs) have been associated with human sepsis but their role is incompletely understood. Stromal cell-derived factor (SDF)-1α facilitates EPC recruitment and is elevated in murine sepsis models. Previous studies have demonstrated that the SDF-1α analog CTCE-0214 (CTCE) is beneficial in polymicrobial sepsis induced by cecal ligation and puncture (CLP) in mice.
Glass fiber manufacturing and fiber safety: the producer's perspective.
Authors: J R Bender, J G Hadley
Journal: Environmental Health Perspectives (1994)

Historically, the potential health effects of airborne fibers have been associated with the dose, dimension, and durability. Increasing focus is being placed on the latter category. Concern about airborne fiber safety could be reduced by manufacturing fibers that are not respirable; however, due to performance and manufacturing constraints on glasswool insulations, this is not possible today. These products are an important part of today's economy and as a major manufacturer, Owens-Corning is committed to producing and marketing materials that are both safe and effective in their intended use. To this end, manufacturing technology seeks to produce materials that generate low concentrations of airborne fibers, thus minimizing exposure and irritation. The range of fiber diameters is controlled to assure effective product performance and, as far as possible, to minimize respirability. Glass compositions are designed to allow effective fiber forming and ultimate product function. Fiber dissolution is primarily a function of composition; this too, can be controlled within certain constraints. Coupled with these broad parameters is an extensive product stewardship program to assure the safety of these materials. This article will discuss the factors that influence glasswool insulation production, use, and safety.
Allergen exposure and maternal antibody as risk factors for the development of IgG and IgE responses to Fel d I and der f I at age 2–3 years
Authors: Elizabeth Erwin, Anne B Allison, Marisa Barr, Harriet Burge, Diane Sredl, Diane Gold, Thomas AE Platts-Mills
Journal: Journal of Allergy and Clinical Immunology (2002)
FDA warns that antidepressants may increase suicidality in adults
Authors: Jeanne Lenzer
Journal: BMJ (2005)

The US Food and Drug Administration last week reiterated its warning that adults treated with antidepressants must be closely observed by their doctors in case they experience worsening of depression and “increased suicidal thinking or behavior.”

Agency officials simultaneously posted new information that a “higher than expected rate of suicide attempts was observed” among patients taking the antidepressant duloxetine (manufactured by Eli Lilly and marketed in the United States as Cymbalta).

Eli Lilly has objected to the FDA's warning about duloxetine. According to a report in the Wall Street Journal (1 July; …
Gordon Ian Cameron
Authors: E. Cameron
Journal: BMJ (2013)

Educated in Scotland, Gordon Ian Cameron qualified as a doctor before doing national service as regimental medical officer to the 3rd Royal Tank Regiment in Hong Kong and then to the 2nd/10th Gurkha Rifles in the Malayan jungle. The latter appointment left him with an enduring high regard for those Nepalese hill men.

He moved to Hessle in East Yorkshire in 1950 and was married to Jean Nelson in 1952. Theirs was a long and happy union, which lasted until her death in 2008. He was a …
CELLULAR DIFFERENTIATION OF THE IMMUNE SYSTEM OF MICE
Authors: G. Cudkowicz, G. M. Shearer, R. L. Priore
Journal: The Journal of Experimental Medicine (1969)

Marrow cells and thymocytes of unprimed donor mice were mixed in vitro and transplanted into X-irradiated syngeneic hosts. 18 hr later sheep erythrocytes were injected to induce immune responses. Splenic plaque-forming cells (PFC) secreting IgM (direct PFC) or IgG (indirect PFC) hemolytic antibody were enumerated at the time of peak responses. By transplanting graded and limiting numbers of marrow cells with 5 x 10(7) thymocytes, inocula were found that contained few precursors of PFC (P-PFC) reaching the recipient spleens, interacting with thymocytes, and generating PFC. However, the frequency of responses in relation to the number of grafted marrow cells did not follow Poisson statistics, presumably because the interaction of marrow cells with thymocytes was more complex than a single or a one-to-one cell event. The frequency of direct PFC responses was greater than that of indirect PFC responses in 13 of 15 groups of mice tested. This was interpreted as evidence for the existence of two classes of P-PFC, each of which was restricted to generate either direct or indirect PFC. The precursors of direct PFC were approximately 15 times more frequent than those of indirect PFC. Since thymic antigen-reactive cells were not differentiated for antibody class, it follows that antigen-sensitive units reactive to sheep erythrocytes owe their class restriction to specialized marrow cells. Specialization of P-PFC may have arisen within marrow cell lines by differentiation, or may have been conferred upon P-PFC by interaction with other cells, including those of the irradiated host.
The Littlest Cardiologist
Authors: Peter J. Mariani
Journal: JAMA (1990)

<h3>To the Editor.—</h3> A 20-year-old gravida 1, para 0 woman in her sixth month of an uncomplicated pregnancy presented to the emergency department 1 hour after being awakened by rapid, regular palpitations. There were no associated symptoms. Approximately 1 year previously, she had experienced a similar episode, which terminated spontaneously after 2 minutes and did not compel her to seek medical attention. Further investigation of medical history and review of systems revealed no predisposition to tachyarrhythmia other than her taking oral theophylline and inhaled metaproterenol for asthma. Initial vital signs were as follows: blood pressure, 104/80 mm Hg; pulse rate, 178 beats per minute; respirations, 22/min; and temperature, 37.1°C. With the exception of mild apprehension and a rapid, regular heartbeat and pulse, the results of the physical examination were those of a normal pregnant woman. An intravenous line was started. Cardiac monitoring and an electrocardiogram revealed supraventricular tachycardia at a
Augmentation of neutral sodium chloride absorption by increased flow rate in rat ileum in vivo.
Authors: M S Harris, J W Dobbins, H J Binder
Journal: Journal of Clinical Investigation (1986)

Studies in intact animals have shown that intestinal solute absorption is enhanced with increasing flow rates; the mechanism of this phenomenon has not been explored in detail. We used single pass perfusions of rat ileum to study the effect of higher flow rate on electrolyte absorption. Augmenting perfusion rate from 0.5 to 5.0 ml/min resulted in increased rates of sodium (11.0 +/- 0.9 vs. 23.5 +/- 2.7 mueq/min X g) and chloride (12.1 +/- 0.8 vs. 25.0 +/- 2.2 mueq/min X g) absorption, reduction in the estimated unstirred layer thickness (668 +/- 31 vs. 433 +/- 28 micron), minimal changes in intraluminal pressure and transmural potential difference, and a small, though significant, increase in intraluminal volume (19.4 +/- 8.4%). Removal of sodium from the perfusion medium abolished the effect of increased flow rate on chloride absorption as did removal of chloride on sodium absorption; addition of furosemide or acetazolamide to Ringer's solution also inhibited this effect. In separate experiments, stepwise increases in intraluminal volume were induced by elevating the outflow tubing; no effect on electrolyte transport was observed. These studies demonstrate that neutral sodium chloride absorption is enhanced in rat ileum at higher flow rates, perhaps as a result of a decrease in the thickness of unstirred layers.
Preventing Blindness in Premature Infants
Authors: Arlene V. Drack
Journal: New England Journal of Medicine (1998)

In 1942 Terry reported a retinal vasculopathy causing blindness in premature infants.1 The condition was called retrolental fibroplasia, because a fibrovascular mass could be seen behind the crystalline lens. Hundreds of babies in the United States still become blind or visually handicapped each year from this disease, now known as retinopathy of prematurity.Initially, the cause appeared to be excess oxygen. In the 1940s and 1950s, premature infants were treated with high concentrations of oxygen to keep them alive. In the absence of a noninvasive method of measuring blood oxygen saturation, there was no way to titrate the amount of . . .
Gallium Scan Diagnosis of Sarcoidosis in the Presence of Equivocal Radiographic and CT Findings
Authors: EDWARD R. SAVOLAINE, PAMELA J. SCHLEMBACH
Journal: Clinical Nuclear Medicine (1990)

In a patient with nonspecific radiographic findings, Ga-67 imaging was suggestive of findings consistent with sar-coidosis including lacrimal gland uptake. The diagnosis was established by lacrimal gland biopsy. Sites of sar-coid involvement in the chest and abdomen were identified on Ga-67 imaging. Less accurate demonstration of these areas was seen on chest radiograph and CT scanning.