tbuckley/cabot-search huggingface dataset:
Mobile phones go molar
Authors: Claire McKenna
Journal: BMJ (2002)

An innovative design for a tooth implant that can receive digital signals from radios, computers, and mobile phones is on display at the London Science Museum this summer.



The creators envisage that a microvibration device and a wireless receiver would be implanted in the tooth during routine dental surgery. The sound is then transferred from the tooth into the inner ear by bone conduction, converting the …
CAL02, a novel antitoxin liposomal agent, in severe pneumococcal pneumonia: a first-in-human, double-blind, placebo-controlled, randomised trial
Authors: Pierre-François Laterre, Gwenhael Colin, Pierre-François Dequin, Thierry Dugernier, Thierry Boulain, Samareh Azeredo da Silveira, Frédéric Lajaunias, Antonio Perez, Bruno François
Journal: The Lancet Infectious Diseases (2019)
Charge selectivity of the glomerular filtration barrier in healthy and nephrotic humans.
Authors: A Guasch, W M Deen, B D Myers
Journal: Journal of Clinical Investigation (1993)

We used dextran sulfate (DS) to evaluate barrier charge selectivity in 11 nonproteinuric subjects and in 11 patients with the nephrotic syndrome due to either membranous nephropathy or minimal change nephropathy. The 3H-DS preparation spanned a molecular radius interval of 10-24 A and exhibited size-dependent protein binding in vitro. Urine and ultrafiltrates of plasma were separated by size into narrow fractions using gel permeation chromatography. The sieving coefficient (theta) for ultrafilterable DS of 15A radius averaged 0.68 +/- 0.03 in nonproteinuric vs. 0.95 +/- 0.05 in nephrotic subjects (P < 0.001). Uncharged dextrans of broad size distribution were used to evaluate barrier size-selectivity in separate groups of nonproteinuric subjects (n = 19) and nephrotic patients with either minimal change (n = 20) or membranous nephropathy (n = 27). The value of theta for an uncharged dextran of similarly small radius (approximately 18 A) was significantly larger than that observed for DS in nonproteinuric subjects, but was similar in nephrotic individuals. Further, impaired barrier size-selectivity, as assessed by the sieving profile for uncharged dextrans (18-60 A radius), failed to account fully for the observed level of albuminuria in almost half of the patients with either minimal change (9/20) or membranous nephropathy (12/27). Together these findings suggest that the human glomerular capillary wall normally provides an electrostatic barrier to filtration of negatively charged macromolecules such as albumin, and that impairment of this electrostatic barrier contributes to the magnitude of albuminuria in the nephrotic syndrome.
Minerva: November 1999
Authors: Imtiaz Ahmed, A Ilchyshyn
Journal: BMJ (1999)

Women in Detroit can now get more than hot rollers and highlights at their weekly trip to the hair salon. In a campaign to cut high rates of hypertension, diabetes, and renal disease among the city's African-Americans, the National Kidney Foundation of Michigan is teaching stylists to spot suspicious symptoms and encourage their clients to see a doctor ( Detroit News , 9 September 1999). The scheme could go nationwide if it is successful, although it's still unclear how women will respond to being probed about their health while trapped under a hair dryer.

The helicopter ambulance in Tromso, a rural area in north Norway, takes about 20 minutes to get airborne after an emergency call. Emergency medicine specialists estimate, however, that speeding up the take off would make little difference to the patients ( Prehospital Immediate Care 1999;3:136-9). An expert panel reviewed 65 cases over two years - 51 deaths and 14 survivors with ongoing problems - and concluded that shortening the response time by 15 minutes would have improved the outcome in only two patients; a 6% increase in life years gained across the board.

Electroconvulsive therapy has …
Look back to go forward
Authors: Prizzi Zarsadias
Journal: BMJ (2009)

As the year draws to a close people tend to ponder over the past. Reflecting on the past is an opportunity to learn from mistakes, or what my communication skills tutor would say, what I “could do better.” In the clinical setting the official term for a mistake is an “adverse event,” which is when medical intervention causes harm to a patient or the safety margin was reduced (also known as a “near miss”). Sometimes whispered on wards around the world, the start of the academic year is dubbed a hazardous time of year to be an inpatient. The assumption was that …
Publisher Correction: The UMBRELLA SIOP–RTSG 2016 Wilms tumour pathology and molecular biology protocol
Authors: Gordan M. Vujanić, Manfred Gessler, Ariadne H. A. G. Ooms, Paola Collini, Aurore Coulomb-l’Hermine, Ellen D’Hooghe, Ronald R. de Krijger, Daniela Perotti, Kathy Pritchard-Jones, Christian Vokuhl, Marry M. van den Heuvel-Eibrink, Norbert Graf
Journal: Nature Reviews Urology (2019)
A patient with abdominal pain
Authors: Lynda Djabella, Nanda Kumar
Journal: BMJ (2007)

A previously fit and well 36 year old woman presented at the emergency department with a three week history of sudden onset severe abdominal pain and vomiting. The pain settled and she was discharged with proton pump inhibitors. However, a week later she continued to feel unwell and was seen by her on-call general practitioner.

She complained of a continuing feeling of left hypochrondrial abdominal pain that did not radiate and generally feeling unwell. She had no associated symptoms of nausea or vomiting, weight loss or anorexia. The pain was not relieved on rest and there was no relation to food. She did not smoke and drank on average 4-5 units of alcohol a month. There were no other aggravating or relieving factors. She was not taking any drugs and had no noteworthy previous medical or family history. For contraception, she had had a depot injection two months before.

Before seeing her general practitioner she had been to the local emergency department, where, after clinical examination, she was discharged given proton pump inhibitors …
Cardiovascular Outcomes of Calcium-Free vs Calcium-Based Phosphate Binders in Patients 65 Years or Older With End-stage Renal Disease Requiring Hemodialysis
Authors: Julia Spoendlin, Julie M. Paik, T. Tsacogianis, Seoyoung C. Kim, Sebastian Schneeweiss, Rishi J. Desai
Journal: JAMA Internal Medicine (2019)

Guidelines restricting use of calcium-based phosphate binders in all patients with end-stage renal disease owing to their potential contribution to increased cardiovascular risk shifted prescribing from calcium acetate toward the costlier sevelamer carbonate products.To compare cardiovascular events and mortality between patients with end-stage renal disease (ESRD) undergoing hemodialysis receiving sevelamer vs calcium acetate in real-world practice.An observational cohort study was conducted using the United States Renal Data System linked to Medicare claims data (May 1, 2012, to December 31, 2013). Data analysis was performed from October 2017 to September 2018. Participants included patients 65 years or older with ESRD within 180 days after starting hemodialysis (sevelamer, 2647; calcium acetate, 2074).New use of sevelamer (calcium-free phosphate binder) vs calcium acetate (calcium-based phosphate binder).Hazard ratios (HRs) with 95% CIs were estimated for fatal or nonfatal cardiovascular events (myocardial infarction or ischemic stroke: primary outcome) and all-cause mortality (secondary outcome) using Cox proportional hazards regression with fine stratification on the propensity score to control for potential confounders, including phosphorus and calcium levels.After propensity score weighting, 2639 patients initiating sevelamer treatment (1184 men [44.9%]; mean [SD] age, 75.6 [6.9] years) and 2065 patients initiating calcium acetate treatment (930 men [45.0%]; mean [SD] age, 75.5 [7.1] years) were included in the analysis. Crude incidence rates (IRs) for cardiovascular events of 458 per 1000 person-years for sevelamer and 464 per 1000 person-years for calcium acetate were observed. After propensity score fine-stratification weighting, HRs of 0.96 (95% CI, 0.84-1.10) for cardiovascular events were observed. Results were consistent within subgroups of age (<75 y: primary outcome, HR, 1.02; 95% CI, 0.85-1.24; vs ≥75 years: primary outcome, HR, 0.83; 95% CI, 0.69-1.01) and sex (primary outcome in men: HR, 1.02; 95% CI, 0.83-1.26).The results of the study do not suggest increased cardiovascular safety of sevelamer in the routine clinical practice of patients with ESRD compared with calcium acetate; this study's findings suggest that well-designed, long-term, randomized clinical trials are needed.
Clinical exam skills: A handy sign
Authors: Ian Bickle, Elisabeth McCausland
Journal: BMJ (2005)

A 32 year old woman presented with an eight month history of being “out of sorts.” Five months before she had had an elective ear, nose, and throat procedure in a district hospital. In the months after her admission she had regularly visited her general practitioner with a number of symptoms, which included tiredness, joint pains, facial pains, and a recurrent stuffy nose. At the time of admission to hospital in addition to the above she complained of sore red eyes.

On examination, there was evidence of bilateral conjunctival injection. She had tender small joints in the hands, knees, ankles, and elbows. Nail fold infarcts were also noted (fig 1).



Fig 1 
Nail fold infarcts



1.  Describe the findings in the hands and give differential diagnoses for their cause.
        Computed tomography imaging taken before the previous ear, nose, and throat surgery was retrieved from the district hospital (fig 2).

2.  Outline any abnormalities seen in this image.
        After a consultation with an ophthalmologist, anterior uveitis was confirmed. Her initial blood results (reference range) were …
Aberdeen surgeons pioneer hand surgery in the UK
Authors: Roger Stevens
Journal: BMJ (2001)

A Russian professor of hand surgery is visiting Aberdeen in Scotland to teach a pioneering technique to lengthen congenitally underdeveloped or amputated fingers. Professor Husseinali Ismailov, head of hand and foot surgery at the Russian Ilizarov scientific centre for restorative traumatology and orthopaedics in Kurgan, Russia, is teaching his method (the Ilizarov method, or transosseous osteosynthesis) to plastic and orthopaedic surgeons at Aberdeen Royal Infirmary.

Professor Ismailov said, “The technique involves external fixation of the long, small, and spongy bones in which wires are passed through the skin and bones and attached to …
Girls hit at home are more likely to be hit by boyfriends
Authors: Richard Hurley
Journal: BMJ (2005)

Teenage girls who are hit by their parents are more likely to experience violence from their boyfriends. A survey of teenage girls in the United Kingdom has found that violence against women by a partner can start at a young age.



PHANIE/REX



Sixteen per cent of teenage girls have been hit at least once by their boyfriend, and for 4% the violence is recurring. …
Abstract 18032: Psychological Stressors and Atrial Fibrillation in Middle-Aged and Older Women
Authors: Sarah K Westcott, Fumika Matsushita, Christine M Albert, Neal Chatterjee, Jorge Wong, David Williams, M. Vinayaga Moorthy, Alan M Zaslavsky, Julie Buring, Michelle A Albert
Journal: Circulation (2016)

Background: Negative emotions have been linked to the development atrial fibrillation (AF), and positive affect may be protective. However, there are few large-scale studies about the association of psychological stressors that may provoke these emotions with the occurrence of AF. Methods and Results: We examined the cross-sectional relationship between psychological stress and AF among 26,208 women participating in the Women’s Health Study cohort (mean age = 72.4 ± 6.0 years). Participants answered questions about perceived stress (e.g. upset by something unexpected, lack of control), work stress (e.g. excessive work, conflicting demands), work-family conflict (e.g. too stressed after work to participate in activities with family), financial stress (e.g. difficulty paying monthly bills), traumatic life events (e.g. death of a child), everyday discrimination (e.g. less respect, poor service), intimate partner stress (e.g. how judgmental is your spouse/partner) and neighborhood stress (e.g. neighborhood sa...
Film review: The Virgin Suicides
Authors: Russell Viner
Journal: BMJ (2000)

Adolescent angst, crazy psychiatrists, blood in the bath, religious repression, flares, and silly haircuts. This beautifully filmed novel about the suicides of five teenage sisters in 1970s Michigan, made by the Coppola family, fails to miss a cliche while also providing a poignant insight into suicide in young people.



Five sisters failed by the system (PATHE)



Told as a verbal jigsaw puzzle by clueless adolescent lads trying to understand the horror that happened next door, the film skillfully contrasts the incomprehensibility of the girls' suicides to outsiders with an insightful portrayal of the personal powerlessness …
This is not a freak show
Authors: Neil Graham
Journal: BMJ (2009)

This wasn't the first time that I'd visited one of Gunther von Hagens's offerings, but with three gruelling years of medical school since my last visit, I wondered if this time I'd see things differently.



Body Worlds and the Mirror of Time features material from more than 200 cadavers, painstakingly dissected to show the finer points of anatomy and the process of ageing. Von Hagens also includes three plastinated chickens, a horse, a giraffe, many human fetuses, and an assortment of human body parts. Plastination is a technique used in anatomy to preserve bodies or body parts that preserves microstructure. This is not a show of blood, guts, and gore.

The specimens are accompanied by concise explanations. Walking among them is fascinating, and having studied anatomy only adds …
Exposure to Maternal Depressive Symptoms in Fetal Life or Childhood and Offspring Brain Development: A Population-Based Imaging Study
Authors: Runyu Zou, Henning Tiemeier, Jan van der Ende, Frank C. Verhulst, Ryan L. Muetzel, Tonya White, Manon Hillegers, Hanan El Marroun
Journal: American Journal of Psychiatry (2019)

The authors examined associations of exposure to maternal depressive symptoms at different developmental stages from fetal life to preadolescence with child brain development, including volumetrics and white matter microstructure.This study was embedded in a longitudinal birth cohort in Rotterdam, the Netherlands. Participants were 3,469 mother-child pairs with data on maternal depressive symptoms and child neuroimaging at age 10. The authors also measured child emotional and behavioral problems at the time of neuroimaging. The association of maternal depressive symptoms with child brain development at each assessment was examined. Maternal depressive symptom trajectories were modeled across fetal life and childhood to determine the association of maternal depressive symptom patterns over time with child brain development.The single-time-point analyses showed that maternal depressive symptoms at child age 2 months were associated with smaller total gray matter volume and lower global fractional anisotropy (FA), whereas maternal depressive symptoms assessed prenatally or in childhood were not. The trajectory analyses suggested in particular that children exposed to persistently high levels of maternal depressive symptoms across the perinatal period had smaller gray and white matter volumes as well as alterations (i.e., lower FA) in white matter microstructure compared with nonexposed children. Furthermore, the gray matter volume differences mediated the association between postnatal maternal depressive symptoms and child attention problems.Perinatal maternal depressive symptoms were consistently associated with child brain development assessed 10 years later. These results suggest that the postnatal period is a window of vulnerability for adversities such as maternal depressive symptoms.
Hurricane Katrina: medical students and trainee doctors caught up in chaos
Authors: Douglas P Olson
Journal: BMJ (2005)

The devastation unleashed by hurricanes Katrina and Rita plunged many peoples' lives into chaos. The training of medical students and doctors was not spared. Douglas P Olson investigates

More than 2000 medical students, doctors in training, and graduate students were among those affected on 29 August as hurricane Katrina hit the US coast near New Orleans, Louisiana, as a category 4 storm. Katrina is the strongest hurricane to hit the US mainland since 1969. The hurricane brought 140 mile an hour (225 km an hour) winds and considerable flooding to the city and its environs, causing extensive damage to people and property.

Although New Orleans's well known sobriquet the Big Easy suggests capricious times and enjoyment, the weeks after the storm have been anything but easy at Tulane and Louisiana State universities. Medical trainees lost nearly everything books, cars, clothes, and a year of medical education.

Students and junior doctors, starting a new academic year, were forced to evacuate the city. Many trainees from Tulane University were relocated to Houston and Galveston in Texas. Less than a month later, on 24 September, another hurricane, Rita, hit land near the Louisiana Texas border. Many of the 5000 medical students and doctors in training in Texas were evacuated again. Although hurricane Rita caused flooding and damage in Texas, its damage was far less than the devastation caused by Katrina in Louisiana and Mississippi. The effects of Katrina on the medical students and trainees will last longer.

Long term implications for medical education in the region remain unclear, but the short …
Abstract 11778: Association of Body Mass Index With Corrected QT interval and the Impact of This Association on All-cause Mortality: Results From the National Health and Nutrition Examination Survey (NHANES)
Authors: Salman Waheed, Buddhadeb Dawn, Kamal Gupta
Journal: Circulation (2015)

Introduction: Given the high prevalence of obesity, the association of body mass index (BMI) with corrected QT interval (QTc) warrants investigation. Although both BMI and QTc are independently associated with mortality, the influence of BMI on QTc and the specific impact of this association on mortality remain unknown. Methods: We analyzed data from 4,579 participants aged 40-65 years from NHANES III for a median of 13.8 years. We divided the weighted sample into 4 categories by BMI as 18.5-25 (reference), &gt;25-30, &gt;30-35 and &gt;35 and 2 categories by Bazette heart rate-corrected QT as normal (&lt;450 ms in males, &lt;460 ms in females) or prolonged. Cox proportional hazards models were used with adjustment for demographic characteristics and traditional cardiovascular risk factors. Results: BMI was significantly associated with QTc with a significantly higher QTc among those with higher BMI (Mean QTc: 428, 429, 433 and 439 ms respectively for BMI 18.5-25, &gt;25-30, &gt;30-35 and &gt;35, P for trend: &lt;0.001). Overall, both prolonged QTc or BMI&gt;35 were independently associated with increased mortality compared with those with normal QTc or BMI 18.5-25. When combined, the risk of mortality was higher among those with both prolonged QTc and higher BMI [Hazard ratio (95% CI): 1.92 (1.03-3.56), 1.75 (0.83-3.68) and 2.29 (1.12-4.69)] for categories of prolonged QTc and BMI 25-30, 30-35 and &gt;35, respectively compared with those with BMI 18.5-25 and normal QTc. There was a significant improvement in risk prediction for mortality when QTc was added to the fully adjusted model with BMI (net reclassification index 0.167, P=0.0001). Conclusions: Those with higher BMI have a significantly longer QTc. This longer QTc among those with higher BMI translates into a higher risk of mortality. These novel observations suggest that individuals with higher BMI should be screened for the presence of prolonged QTc, especially when treated with medications that may prolong QTc.
Tips on - Testicular self examination
Authors: Rahul Mistry
Journal: BMJ (2005)

Unlike many types of cancer, testicular cancer most often affects young adults. Nearly 2000 men are diagnosed with the disease in the United Kingdom each year. It is the most common malignancy in 15 to 45 year old men.1

Regular testicular examination is recommended for men to detect testicular cancer in its early stages. Many testicular cancers are first discovered by men themselves, or their sexual partners, as a lump or enlarged swollen testicle.

Self examination is important in the diagnosis of …
No Plan B for over the counter contraceptive
Authors: Janice Hopkins
Journal: BMJ (2004)

Family planning groups, women's organisations, obstetricians and gynaecologists, legislators, and national newspapers in the United States recently protested at the Food and Drug Administration's (FDA's) refusal to permit sales over the counter (without a prescription) of an emergency contraceptive.

In making its decision the FDA over-ruled its own scientific advisory committee and its professional staff.

Many experts said it was an attack on contraception by the antiabortion Bush administration. But Dr …
Doctors leaving the NHS early should ‘resign’, not ‘retire’
Authors: Amina Hussain
Journal: BMJ (1999)

“The NHS is a crap employer. It has the crappiest record on employment of any west European country,” said Dr Chris Manning, the co-chair of Primary Care Mental Health Education, at a conference on doctors under stress at the Royal Society of Medicine in London on 15 November.

Although he admitted to having had depression for a long time, Dr Manning was the most ebullient speaker of the day. With regard to stress in general practitioners, he believed that a lot of the newer recruits were going to put themselves first, “because the message they get is that the country doesn't care about you.” Having retired from the NHS …
The gut microbiota and graft-versus-host disease
Authors: David N. Fredricks
Journal: Journal of Clinical Investigation (2019)

Graft-versus-host disease (GvHD) is a common complication of hematopoietic cell transplantation that negatively impacts quality of life in recipients and can be fatal. Animal experiments and human studies provide compelling evidence that the gut microbiota is associated with risk of GvHD, but the nature of this relationship remains unclear. If the gut microbiota is a driver of GvHD pathogenesis, then manipulation of the gut microbiota offers one promising avenue for preventing or treating this common condition, and antibiotic stewardship efforts in transplantation may help preserve the indigenous microbiota and modulate immune responses to benefit the host.