tbuckley/cabot-search huggingface dataset:
Focus: Westminster NHS on election back burner
Authors: J. Warden
Journal: BMJ (1997)

Public opinion polls in Britain consistently place the NHS high on the list of what people regard as “most important”–though so far in this general election the NHS has been conspicuous mainly by its absence as an issue. In fact, close examination would show more convergence than contrast between the parties' health policies. And while Labour is perceived by the public to have the best policies on health, the reality is that a Labour government will not radically change what is already in place.

Within sight of its 50th anniversary, the NHS is a durable survivor of Britain's postwar socialised services: state run, tax funded, and universally available–despite having been under Conservative rule for 35 of these years. Half that stewardship has …
GROUP SUSCEPTIBILITY TO ACUTE, UPPER RESPIRATORY TRACT INFECTIONS
Authors: WILLIAM H. BARROW
Journal: JAMA (1926)

A rather comprehensive review of the literature on the so-called common cold and upper respiratory tract infections of the influenzal type made by Townsend<sup>1</sup>of the United States Public Health Service indicates that "there has been little advance in any knowledge concerning its etiology, epidemiology, periodicity, or the establishment of definite symptoms, pathognomonic in its diagnosis." It therefore would seem that any study of possible factors governing the susceptibility to "colds" is worth reporting, since even negative conclusions help at least to narrow the field of investigation. Smiley<sup>2</sup>of Cornell University in connection with a study of the incidence of "colds" among Cornell students, divided these men and women into three groups: (1) those having "colds" not at all or once a year; (2) those reporting two or three "colds" a year, and (3) those having four or more a year. A questionnaire was sent to groups 1
Relationship Between Retinal Blood Flow and Renal Function in Patients With Type 2 Diabetes and Chronic Kidney Disease
Authors: Taiji Nagaoka, Akitoshi Yoshida
Journal: Diabetes Care (2012)

OBJECTIVE To study the relationship between retinal microcirculation and renal function in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Using a laser Doppler velocimetry system, we obtained the retinal blood flow (RBF) values by simultaneously measuring the retinal vessel diameter and blood velocity. To determine if the RBF is affected in the presence of renal dysfunction, we also evaluated the renal function using the estimated glomerular filtration rate calculated by age and serum creatinine level. RESULTS We recruited 169 eyes of 169 consecutive Japanese patients with type 2 diabetes, no or minimal diabetic retinopathy, and normo/microalbuminuria (mean age ± SD, 59.0 ± 11.1 years). We divided the patients into four groups based on the stage of chronic kidney disease (CKD) (non-CKD, n = 99; CKD stage 1, n = 22; stage 2, n = 27; stage 3, n = 21). We found significant (P = 0.035) decreases in RBF with decreased vessel diameter (P = 0.017) but no difference in blood velocity (P = 0.54) in stage 3 CKD compared with the non-CKD group. Multiple regression analysis showed that the CKD stage was significantly (P = 0.02) and independently associated with decreased RBF. CONCLUSIONS Our results indicated that the vessel diameter and RBF in the retinal arterioles decrease in patients with type 2 diabetes with stage 3 CKD, suggesting that impaired renal function might be associated with decreased RBF, probably via constriction of the retinal arterioles, in early-phase diabetic retinopathy.
Listing and Transplanting Adults With Congenital Heart Disease
Authors: Ryan R. Davies, Mark J. Russo, Jonathan Yang, Jan M. Quaegebeur, Ralph S. Mosca, Jonathan M. Chen
Journal: Circulation (2011)

An increasing number of patients with congenital heart disease (CHD) are reaching adulthood and may require heart transplantation. The survival of these patients after listing and transplantation has not been evaluated.A total of 41 849 patients (aged >18 years) were listed for primary transplantation during 1995-2009. Patients with a history of CHD (n=1035; 2.5%) were compared with those with other causes (non-CHD group) (n=40 814; 97.5%); 26 055 (62.3%) reached transplantation and were subdivided into those with (reoperation group; n=10 484; 40.2%) and without (nonreoperation group; n=15 571; 59.8%) a previous sternotomy. Survival on the waiting list was similar between groups, but mechanical ventricular assistance was not associated with superior survival to transplantation among CHD patients. CHD patients were more likely to have body mass index <18.5 at transplantation (P<0.0001), were younger, and had fewer comorbidities. Early mortality among patients with CHD was high (reoperation, 18.9% versus 9.6%; P<0.0001; nonreoperation, 16.6% versus 6.3%; P<0.0001), but by 10 years, overall survival was equivalent (53.8% versus 53.6%). Analysis was limited by the lack of specific information regarding the CHD diagnosis in most patients.Adults with CHD have high 30-day mortality but better late survival after heart transplantation. Mechanical circulatory assistance does not improve waiting list survival in these patients. This may be due to a combination of highly complex reoperative surgery and often poor preoperative systemic health.
AN AMBULATORY DISTRACTION SPLINT FOR LEG FRACTURES
Authors: E. Robert
Journal: BMJ (1932)

The absence of addisin in the gastric juice in pernicious anaemia is the cause, we believe, for the reversion to a megaloblastic marrow in this disease.The lack of a satisfactory test for the presence of addisin in concentrated gastric juice, save its injection into a patient with perni- cious anaemia, is a handicap, as it has been in the case of liver extract and ventriculin.Experiments are under way, both biological and chemical, to try to overcome this difficulty.The observations we have made up to the present time indicate the probability that addisin is the physiological hormone which maintains the normal state of the blood in health.The therapeutic effect of intramuscular injections of addisin in secondary anaemias is under investigation.
Peritonitis after percutaneous endoscopic gastrostomy and jejunostomy: where there is smoke, there may not be fire
Authors: S. Faias, G. Buck, M. DeLegge
Journal: Endoscopy (2006)

Extensive reviews have been published regarding complications arising from percutaneous enteral access and ways of managing them. However, few data are available regarding unnecessary clinical interventions resulting from misinterpretation of benign postprocedural findings. We present here three representative cases of negative surgical abdominal cavity explorations for presumed peritonitis after percutaneous endoscopic gastrojejunostomy and jejunostomy.
Combinatorial effects of microRNAs to suppress the Myc oncogenic pathway
Authors: María J. Bueno, Marta Gómez de Cedrón, Gonzalo Gómez-López, Ignacio Pérez de Castro, Lorena Di Lisio, Santiago Montes-Moreno, Nerea Martínez, Manuel Guerrero, Ruth Sánchez-Martínez, Javier Santos, David G. Pisano, Miguel Angel Piris, José Fernández-Piqueras, Marcos Malumbres
Journal: Blood (2011)
Tuberculosis sanatoria regimens in the 1940s
Authors: R. Kessel
Journal: Journal of the Royal Society of Medicine (2004)

The personal diary describing a patient's life in a British TB sanatorium in the 1940s reproduced in Raymond Hurt's article (July 2004 JRSM1) reminded me of Betty Macdonald's quite similar experiences in Seattle, Washington, recalled in her much neglected The Plague and I.2 Macdonald was also a patient in the 1940s and although quite different in temperament from Hurt's protagonist, she also was around thirty when first admitted, was the mother of two small children and was fortunate in having a supportive family. Also like Hurt's diarist, she gives a blow-by-blow account of clinical practice at the time. Macdonald's book, however, also contains rich descriptions of the psychosocial histories of the sanatorium's patients and staff as well as providing insight into the difficult adjustments such patients experienced upon their return to the world. Adjustments even more vividly described by Elizabeth Simpson in her account of recovery from tuberculous meningitis some thirty years later.3

These patients' stories deserve to be remembered not merely for what they teach us of history, but perhaps more importantly for what they say about the ways we all deal with recurrent illness.
Facial paralysis after local dental anaesthesia.
Authors: G. Parsons-Smith, J. M. Roberts
Journal: BMJ (1970)

report on aids for the disabled' said, "In theory wheel chairs are prescribed by consul- tants, but in practice few consultants have studied this problem adequately and the re- sponsibility is often passed on to social workers or appliance clerks who have not been trained to do this work.Part of the fault stems from gaps in the doctor's educa- tion, particularly at a postgraduate level, but the situation could be improved by delegating responsibility to physiotherapists or occupational therapists specially trained to assess patients and their wheel-chair needs."The B.M.A. working party estimated that possibly as high as 30% O. of wheel chairs were unsuitable for the patient concerned.This may well be an underestimate.-Weare, etc.,
Importance of "acknowledging and reducing treatment uncertainty" in appraisal and revalidation
Authors: I. Roberts, B. Chaudhry, I. Chalmers
Journal: BMJ (2014)

Last year we criticised the General Medical Council (GMC) for omitting from its 2013 edition of Good Medical Practice its previous view that doctors “must work with colleagues and patients . . . to help resolve uncertainties about the effects of treatments.”1 2 3 We welcome the council’s recently published …
Comparison of mastectomy with tamoxifen for treating elderly patients with operable breast cancer.
Authors: J. F. Robertson, J. H. Todd, I. O. Ellis, C. W. Elston, R. W. Blamey
Journal: BMJ (1988)

STUDY OBJECTIVE--Comparison of tamoxifen and mastectomy in treatment of breast cancer in elderly patients. DESIGN--Randomised trial of treatment of operable breast cancer by wedge mastectomy or tamoxifen, with median follow up 24 and 25 months respectively (range 1-63). SETTING--University hospital; most patients from primary catchment area. PATIENTS--135 consecutive patients with breast cancer aged over 70 with operable tumours (less than 5 cm maximum diameter); 68 were allocated to tamoxifen group and 67 to mastectomy group. Histological diagnosis by biopsy. Two incorrect randomisations in each group. Patient characteristics similar in the two groups and all under care of one surgical team. INTERVENTIONS--Mastectomy group received wedge mastectomy plus excision of symptomatic axillary lymph nodes. Tamoxifen group received continuous treatment with tamoxifen 20 mg twice daily. Patients in tamoxifen group received wedge mastectomy if there was sign of local progression. Those in mastectomy group received further excision or radiotherapy for locoregional recurrence and when local treatments had been exhausted or metastatic disease diagnosed they received tamoxifen. END POINT--Treatment efficacy was assessed by local control of disease and by survival. MAIN RESULTS--Mortality from metastatic cancer in tamoxifen group was 7 (10.6%) and in mastectomy group 10 (15.3%) (NS). There was no difference in survival between the two groups. In mastectomy group 70% remained alive and free of local recurrence at 24 months; in tamoxifen group only 47% remained alive and free of local progression. In mastectomy group locoregional recurrence occurred in 16 patients and metastatic disease in 13; in tamoxifen group locoregional progression occurred in 29 patients and metastatic disease in seven. CONCLUSIONS--As a high proportion of patients treated with tamoxifen eventually required surgery treatment of elderly patients with breast cancer should include mastectomy. Optimum treatment may include both mastectomy and tamoxifen.
Myocardial Infarction Following the Administration of Tetanus Antitoxin
Authors: John F. McManus, James J. Lawlor
Journal: New England Journal of Medicine (1950)

MYOCARDIAL infarction is an infrequently reported complication of serum sickness in man. Rich and Gregory1 comment on the rarity of autopsies in cases of serum sickness among human beings and the paucity of careful clinical studies of the heart in this condition. It has been suggested2 that a greater number of coronary accidents would be found in such cases if the patients were more closely studied.Many recent textbooks of cardiology and allergy ignore serum sickness in a consideration of predisposing and precipitating factors leading to myocardial infarction. However, Scherf and Boyd3 admit that myocardial infarction may develop in cases . . .
Bolus of Methylprednisolone for Aplastic Anemia
Authors: MIGUEL A. SANZ
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 January 1982Bolus of Methylprednisolone for Aplastic AnemiaMIGUEL A. SANZ, M.D., JESUS A. MARTINEZ, M.D., JUAN BESALDUCH, M.D., JAVIER RAFECAS, M.D.MIGUEL A. SANZ, M.D.Search for more papers by this author, JESUS A. MARTINEZ, M.D.Search for more papers by this author, JUAN BESALDUCH, M.D.Search for more papers by this author, JAVIER RAFECAS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-96-1-124_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their interesting paper on heterogeneity of pathogenetic mechanisms in aplastic anemia and their therapeutic implications, Abdou and colleagues (1) have emphasized the role of immune mechanisms in some patients. They reviewed the few reports on in-vitro studies and therapeutic approaches that supported an immune pathogeneity. Only plasmapheresis, cyclophosphamide, and antilymphocyte globulin were considered for therapeutic trials. Recently another immunologic therapeutic approach has been devised: administration of a high dose of methylprednisolone (2). The results of this preliminary report, which described bolus therapy, induced us to give the same treatment to a selected group of patients with...References1. ABDOUVERDIRAMEABDOU NJN. Heterogeneity of pathogenetic mechanisms in aplastic anemia: efficacy of therapy based on in-vitro results. Ann Intern Med. 1981;95:43-50. LinkGoogle Scholar2. BACIGALUPOGIORDANAVAN LINTVIMERCATIMARMONT ADMRA. Bolus methylprednisolone in sever aplastic anemia. N Engl J Med. 1979;300:501-2. Letter. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Ciudad Sanitaria de la Seguridad Social Valencia 9 Spain PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDrug-Induced Blood DisordersMethylprednisolone and Aplastic AnemiaSURAPOL ISSARAGRISIL, M.D., ANONG PAINKIJAGUM, M.D., Ph.D.High doses of gamma globulin and methylprednisolone therapy for idiopathic thrombocytopenic purpura in children 1 January 1982Volume 96, Issue 1Page: 124-124KeywordsAplastic anemiaCyclophosphamideGlobulinsPathogens Issue Published: 1 January 1982 PDF DownloadLoading ...
Osmotic demyelination syndrome
Authors: Rachel Abbott, Eli Silber, Joerg Felber, Enefiok Ekpo
Journal: BMJ (2005)

Patients with chronic alcoholism are commonly admitted to hospital and given intravenous fluids as part of the treatment of alcohol withdrawal. These patients are predisposed to chronic severe hyponatraemia because of a variety of mechanisms including psuedohyponatraemia, hypovolaemia, “beer” potomania syndrome, cerebral salt wasting syndrome, and reset osmostat syndrome.1 If hyponatraemia (serum sodium concentration < 136 mmol/l) is present it is important to correct this slowly, at a rate of less than 8 mmol/l/day to minimise the risk of developing osmotic demyelination syndrome, the general term for central pontine and extrapontine myelinolysis.2

A 42 year old man with chronic alcoholism presented with confusion. He had no significant medical history and was not taking any regular medications. On the day of admission his serum sodium concentration was 105 mmol/l at 5 pm. His serum was hypo-osmolar at 212 mmol/kg and his urine sodium concentration was 22 mmol/l, suggesting hypovolaemia. Over the next 11 hours he was given 1 litre of intravenous 0.9% saline with 40 mmol potassium chloride, followed by another litre over the subsequent 24 hours, as well as intravenous multivitamins (Pabrinex) and oral chlordiazepoxide. His …
Renal Lesions in Acute Rheumatic Fever
Authors: R Gibney, H J Reineck, G A Bannayan, J H Stein
Journal: Annals of Internal Medicine (1981)

In the past 4 years, four patients with acute rheumatic fever and abnormalities of renal function, urinary sediment, or both have undergone percutaneous renal biopsy at this institution. Distinctly different renal lesions were found and included focal glomerulonephritis, classic acute exudative poststreptococcal glomerulonephritis, mesangioproliferative glomerulonephritis, and severe interstitial nephritis. In each case, the clinical abnormalities were transient. In this report we describe the clinical and pathologic findings in each of these patients to stress the variability of renal lesions that may accompany acute rheumatic fever.
Inhibition of cell cycle progression by dual phosphatidylinositol-3-kinase and mTOR blockade in cyclin D2 positive multiple myeloma bearing IgH translocations
Authors: J Glassford, D Kassen, J Quinn, C Stengel, K Kallinikou, A Khwaja, K L Yong
Journal: Blood Cancer Journal (2012)

Multiple myeloma (MM) is a clinically and genetically heterogenous cancer where tumour cells have dysregulated expression of a D-type cyclin, often in association with a recurrent IgH translocation. Patients whose tumour cells express cyclin D2, with the translocation t(4;14) or t(14;16), generally have more proliferative disease and inferior outcomes. The phosphatidylinositol-3-kinase (PI3K) pathway is a major regulator of D-type cyclin expression and cell cycle entry. We evaluated the effect of PI3K pathway blockade on cell cycle behaviour in MM cells, investigating differences between cyclin D2- and cyclin D1-expressing tumours. MM cell lines and primary bone marrow CD138(+) MM cells were exposed to the pan-PI3K/mTOR inhibitor, PI-103, and assessed for cell cycle profiles, [(3)H]-thymidine uptake and cell cycle proteins. We report, in both cell lines and primary MM cells, that PI-103 induced cell cycle arrest with downregulation of cyclin D2 and CDK4/6 in MM cells expressing cyclin D2 via t(4;14) or t(14;16) translocations. Cells expressing cyclin D1 via t(11;14) were insensitive to PI-103, despite exhibiting inhibition of downstream signalling targets. In primary MM cells, PI-103 enhanced the anti-proliferative effects of anti-MM agents. Treatment paradigms including blockade of the PI3K/mTOR pathway should be targeted at patients with IgH translocations associated with cyclin D2 overexpression.
FURTHER COMMUNICATION ON A CURE FOR TUBERCULOSIS.
Authors: R. KOCH
Journal: JAMA (1890)

[Translated forThe Journal. A few months ago in an address before the Inter national Medical Congress, I described a remedy that would render animals refractory to the tubercle bacillus, and would stop the tubercular process in those already affected. Since that time observations have been made upon human beings, which are described in the following pages. It was originally my intention to complete these observations, and to gain extensive experience with the use of the remedy, and also its preparation upon a large scale before publishing anything. But, in spite of all precautions, so much has reached the public, and such false and exaggerated ideas have been formed, that it now seems necessary to avoid further error by giving an account of the present state of the inquiry. Naturally this report can be but brief and many important questions must remain open. The investigations have been carried on under
A "New" Antigen in Leukemia Sera
Authors: Baruch S. Blumberg
Journal: JAMA (1965)

Patients who receive large numbers of transfusions for anemia and other causes may develop precipitins in their blood. These precipitins may react in agar gel double diffusion experiments with specific human serum lipoprotein found in the blood of other individuals. Since these precipitins were found only in patients who had received transfusions they were thought to be antibodies against serum lipoproteins which developed in the patients as a result of the repeated transfusions. The precipitin is referred to as an isoprecipitin since it develops against a specificity found in an individual from the same species. The antilipoprotein isoprecipitin<sup>1,2</sup>developed in approximately 30% of 47 patients with thalassemia who had received transfusions. Isoprecipitins also developed in smaller number of transfused patients with other diseases. All precipitins stained with sudan black, a dye specific for lipid. Immunoelectrophoretic and ultracentrifugal studies showed that the protein with which the isoprecipitins reacted was a
Coronary reserve and exercise ECG in patients with chest pain and normal coronary angiograms.
Authors: P G Camici, R Gistri, R Lorenzoni, O Sorace, C Michelassi, M G Bongiorni, P A Salvadori, A L'Abbate
Journal: Circulation (1992)

Coronary vasodilator reserve is reduced in some patients with a history of chest pain and angiographically normal coronary arteries. ECG changes suggestive of myocardial ischemia during exercise also can be demonstrated in a subset of these patients.We have investigated the correlation between coronary vasodilator reserve, assessed with 13N-labeled ammonia and positron emission tomography, and the ECG during exercise stress in 45 patients with a history of chest pain, angiographically normal coronary arteries, and a negative ergonovine test. ST segment depression on the ECG during exercise was present in 29 of 45 patients. Mean resting left ventricular blood flow was 1.04 +/- 0.22 ml.min-1.g-1; it increased to 1.32 +/- 0.47 ml.min-1.g-1 (p less than 0.01 versus baseline value) during atrial pacing and to 2.52 +/- 0.96 ml.min-1.g-1 (p less than 0.01 versus baseline value) after dipyridamole (0.56 mg/kg i.v.). No regional flow defects could be demonstrated in any patient during pacing or after dipyridamole. Myocardial flows after dipyridamole, however, did not show a normal frequency distribution (Kolmogorov-Smirnov test), and two patient populations could be identified. Twenty-nine (67%) patients had a mean left ventricular flow of 3.02 +/- 0.33 ml.min-1.g-1 after dipyridamole (range, 2.13-5.46 ml.min-1.g-1), and 14 (33%) patients had a mean flow of 1.48 +/- 0.29 ml.min-1.g-1 (range, 1.06-2.04 ml.min-1.g-1, p less than 0.01 versus the "high-flow group").Approximately one third of patients in our series showed a reduced coronary vasodilator reserve. Although 12 of 14 patients in the "low-flow group" had ST segment depression during exercise stress, 16 of 29 patients in the high-flow group also had ST segment depression during exercise stress. Therefore, despite a good sensitivity (86%) in identifying patients with a blunted increment of coronary flow, the ECG response during exercise stress appears to have a rather low specificity (45%). This suggests that factors other than reduced coronary reserve and myocardial ischemia may play a role in the genesis of the ST segment depression in these patients.
Intravenous sotalol decreases transthoracic cardioversion energy requirement for chronic atrial fibrillation in humans: assessment of the electrophysiological effects by biatrial basket electrodes
Authors: Ling-Ping Lai, Jiunn-Lee Lin, Wen-Pin Lien, Yung-Zu Tseng, Shoei K.Stephen Huang
Journal: Journal of the American College of Cardiology (2000)