tbuckley/cabot-search huggingface dataset:
Rite of passage
Authors: Fiona Godlee
Journal: BMJ (2006)

Patients have rights but do they also have responsibilities?John Major's 1991 Citizen's Charter set out for the first time in the UK the right of "consumers" of health care to a certain level of service.It was an important initiative but it got the balance wrong.It made no mention of patients' responsibilities.Why are responsibilities important?Because the patient is central to health care.Luisa Dillner, who set up the BMJ's Best Treatments website for patients, has always (I think rightly) disputed Liam Donaldson's airline analogy for patient safety.Patients should not be seen simply as passengers, entirely dependent for their safety on others.They can actively influence the outcome of care, both for good and bad.Tony Blair's call last week for the nation to take more responsibility for its own health indicates a shift in government thinking, driven partly by the growing cost of unhealthy lifestyles.So what are patients' responsibilities, and do they vary in different healthcare settings?At a meeting last month at the Nuffield Trust, ethicists and others gathered to discuss health care and the public interest.The conveners, Iona Heath, Stephen Pattison, and Martyn Evans, asked us to consider how individual liberty and individual responsibilities could be combined to create justice in a publicly funded health service.We considered examples where public and individual interests clash: immunisation, screening, sharing of data, and even participation in research.Martyn Evans has previously argued that if you are going to benefit from treatments tested on previous patients you have a responsibility to take part in future
Penalizing Hospitals for Chronic Obstructive Pulmonary Disease Readmissions
Authors: Laura C. Feemster, David H. Au
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Section:ChooseTop of pageAbstract <<Historical Perspective: T...Why Might a 30-Day All-Ca...Drawbacks and Potential U...Moving Forward: Improving...ConclusionsReferencesCITING ARTICLES
Importance of patient selection in evaluating a cardiac ambulance service.
Authors: J R Hampton
Journal: BMJ (1976)

All patients brought to hospital by a special cardiac ambulance were followed up and compared with patients carried by routine ambulances to assess the effectiveness of a cardiac ambulance service. The overall mortality of patients with heart attacks was 51% among those carried by an ordinary ambulance and 40% among those carried by the cardiac ambulance. The apparently low mortality in the latter group was balanced, however, by a high mortality (68%) among patients carried by ordinary ambulances when the cardiac ambulance was available but not used; these patients tended to have a short duration of symptoms and heart attacks away from home, and their ambulance was more often called by a member of the public than a general practitioner. It seems therefore that low-risk cases were inadvertently selected for transport by the cardiac ambulance; such unintentional selection makes it difficult to evaluate a cardiac ambulance service.
Determinants and Outcomes of Acute Transcatheter Valve-in-Valve Therapy or Embolization
Authors: Raj R. Makkar, Hasan Jilaihawi, Tarun Chakravarty, Gregory P. Fontana, Samir Kapadia, Vasilis Babaliaros, Wen Cheng, Vinod H. Thourani, Joseph Bavaria, Lars Svensson, Susheel Kodali, Takahiro Shiota, Robert Siegel, E. Murat Tuzcu, Ke Xu, Rebecca T. Hahn, Howard C. Herrmann, Mark Reisman, Brian Whisenant, Scott Lim, Nirat Beohar, Michael Mack, Paul Teirstein, Charanjit Rihal, Pamela S. Douglas, Eugene Blackstone, Augusto Pichard, John G. Webb, Martin B. Leon
Journal: Journal of the American College of Cardiology (2013)
First attack of rheumatic fever in an adult: the case for greater awareness.
Authors: A J Farrell, G C Zaphiropoulos
Journal: Annals of the Rheumatic Diseases (1990)

A 40 year old white woman presenting with rash, fever, and migratory polyarthralgia developed a symmetrical polyarthropathy and remained unwell for 10 weeks. Fulfilment of the revised Jones criteria reinforced the clinical diagnosis of rheumatic fever. Antistreptococcal antibodies peaked four to six weeks into the illness and declined thereafter.
Cancer Incidence in a Population With a High Prevalence of Infection With Human Immunodeficiency Virus Type 1
Authors: C. S. Rabkin, F. Yellin
Journal: JNCI Journal of the National Cancer Institute (1994)

Human immunodeficiency virus type 1 (HIV-1) infection is known to increase the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma. Parallels with other causes of immunodeficiency suggest a possible effect of HIV-1 on additional cancers.This study was designed to determine the types and rates of cancers occurring in excess in the presence of HIV-1 infection.We examined cancer incidence in a population-based open cohort with a high prevalence of HIV-1 infection. The study population was never-married men aged 25-54 years who resided in San Francisco, Calif., of whom an estimated 20,000 (24%) were HIV-1 seropositive as of late 1984. Cancer registration data covering 1,390,000 person-years of observation of these men from 1973 through 1990 were obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Standardized incidence rates and ratios of observed to expected cases (based on rates in the pre-acquired immunodeficiency syndrome [pre-AIDS] period [i.e., 1973-1979]) were calculated for cancers classified by site and by cell type.The incidence of Kaposi's sarcoma in never-married men plateaued in 1988-1990 at 0.5% per year. The incidence of non-Hodgkin's lymphoma increased 20-fold between 1973-1979 and 1988-1990; increases were most pronounced in tumors of higher grade histology and extranodal (especially central nervous system) primary sites. The incidence of Burkitt's and Burkitt-like tumors peaked in 1985-1987, whereas that of large cell diffuse and immunoblastic lymphomas increased throughout the study period. The incidence of Hodgkin's disease was 2.0 (95% confidence interval [CI] = 1.3-3.0) times expected in 1988-1990. The incidence of anal cancer was 9.9 (95% CI = 4.5-18.7) times expected in 1973-1979 and 10.1 (95% CI = 5.0-18.0) times expected in 1988-1990. Ratios of observed to expected cancers of most other sites were 2.0 or less; the ratio of leiomyosarcomas (at any site) was 2.5 (95% CI = 0.5-7.4).As the HIV-1 epidemic has progressed, the increases in AIDS-related Kaposi's sarcoma, Burkitt's tumor, and other non-Hodgkin's lymphoma have followed different patterns. The effect of HIV-1 on other cancers has been nondetectable. In particular, HIV-1 is not related to the increased risk of anal cancer in homosexual men, which antedated the AIDS epidemic.These data suggest that the etiologic mechanisms of HIV-1-related malignancy differ for specific cancers and do not globally increase cancer risk. Control of HIV-1-related cancer remains an unsolved challenge in the management of HIV-1 infection.
A Model Death
Authors: Jack Coulehan
Journal: Annals of Internal Medicine (2000)

On Being a Doctor19 September 2000A Model DeathJack Coulehan, MD, MPHJack Coulehan, MD, MPHState University of New York at Stony Brook; Stony Brook, NY 11794-8036 (Coulehan)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-6-200009190-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Bob Alexander landed in the hospital one day when his right leg collapsed. He was a middle-aged master carpenter who had renal-cell cancer with secondaries throughout his spine, some of which threatened to transect his spinal cord. But Bob was as tough as ironwood. He referred to his tumors as “dry rot.” Why couldn't an orthopedic surgeon go in and scoop them out? Why couldn't he have his spine rebuilt? This was the kind of structural problem that Bob had mastered in his 30 years of repairing and restoring old buildings. Unfortunately, his experience had not prepared him for the ... Author, Article, and Disclosure InformationAffiliations: State University of New York at Stony Brook; Stony Brook, NY 11794-8036 (Coulehan)Corresponding Author: Jack Coulehan, MD, MPH, Department of Preventive Medicine, HSC L3-086, State University of New York at Stony Brook, Stony Brook, NY 11794-8036. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 19 September 2000Volume 133, Issue 6Page: 477-478KeywordsCreativityEmotionsOrthopedicsPersonality disordersPreventive medicineRenal cancerSpinal cordSpineSurgeonsVision ePublished: 19 September 2000 Issue Published: 19 September 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Ureteral Obstruction: Is the Full Metallic Double-Pigtail Stent the Way to Go?
Authors: Evangelos Liatsikos, Panagiotis Kallidonis, Iason Kyriazis, Constantinos Constantinidis, Kari Hendlin, Jens-Uwe Stolzenburg, Dimitrios Karnabatidis, Dimitrios Siablis
Journal: European Urology (2009)
Pathophysiology of Renal Disease
Authors: John E. Engle
Journal: JAMA (1982)

This book summarizes the current state of clinical nephrology and is designed for medical students, house officers, and physicians interested in treating patients with kidney diseases and hypertension. Though there are numerous contributors to the book, the style is consistent and there is little duplication of subject matter. The book is lucid, well organized, and easy to read. The illustrations and photographs are carefully done and add much to the understanding of the textual material. The introductory chapters on clinical evaluation of renal function and the diagnostic approach to the patient with renal disease are especially helpful and should be valuable for medical students and house staff learning to care for patients with renal disorders. The chapters on the pathophysiology of uremia and the treatment of renal failure are also well done and give a good summary of a large area of knowledge. The subjects of fluid and electrolyte and
Lentiviral Delivery of the Human Wild-type Tau Protein Mediates a Slow and Progressive Neurodegenerative Tau Pathology in the Rat Brain
Authors: Raphaëlle Caillierez, Séverine Bégard, Katia Lécolle, Vincent Deramecourt, Nadège Zommer, Simon Dujardin, Anne Loyens, Noëlle Dufour, Gwennaëlle Aurégan, Joris Winderickx, Philippe Hantraye, Nicole Déglon, Luc Buée, Morvane Colin
Journal: Molecular Therapy (2013)

Most models for tauopathy use a mutated form of the Tau gene, MAPT, that is found in frontotemporal dementia with Parkinsonism linked to chromosome 17 (FTDP-17) and that leads to rapid neurofibrillary degeneration (NFD). Use of a wild-type (WT) form of human Tau protein to model the aggregation and associated neurodegenerative processes of Tau in the mouse brain has thus far been unsuccessful. In the present study, we generated an original "sporadic tauopathy-like" model in the rat hippocampus, encoding six Tau isoforms as found in humans, using lentiviral vectors (LVs) for the delivery of a human WT Tau. The overexpression of human WT Tau in pyramidal neurons resulted in NFD, the morphological characteristics and kinetics of which reflected the slow and sporadic neurodegenerative processes observed in sporadic tauopathies, unlike the rapid neurodegenerative processes leading to cell death and ghost tangles triggered by the FTDP-17 mutant Tau P301L. This new model highlights differences in the molecular and cellular mechanisms underlying the pathological processes induced by WT and mutant Tau and suggests that preference should be given to animal models using WT Tau in the quest to understand sporadic tauopathies.
Interstitial Pneumonitis Associated with Sirolimus Therapy in Renal-Transplant Recipients
Authors: Emmanuel Morelon, Marc Stern, Henri Kreis
Journal: New England Journal of Medicine (2000)

To the Editor: Sirolimus is a new, highly potent immunosuppressive drug1,2 that was recently licensed in the United States and is currently being evaluated in phase 3 clinical trials in Europe. The...
A NEW TONSILLECTOME
Authors: J. Ellis Jennings
Journal: JAMA (1913)

This new tonsillectome was designed to remove the tonsil in its capsule by the Sluder method. The essential and distinctive feature of this operation is the moving of the tonsil completely out of its normal bed forward and upward onto the eminence of the lower jar produced by the last molar tooth, and the utilization of this prominence in putting the tonsil through the aperture of the guillotine. For this operation a tonsillectome of great strength and leverage power is essential. To attain these ends Dr. Sluder has modified the Physick-Mackenzie guillotine by doubling the thickness of the shaft, shortening its length and making the handle longer. In using this instrument with its dull blade I found considerable difficulty in exerting sufficient pressure with the thumb to cut through the tissues. In consequence they were bruised and torn before the tonsil was removed. In thinking over the matter it seemed
The Use of Ascorbate Dilution Curves in Cardiovascular Diagnosis
Authors: PETER L. FROMMER, WILLIAM W. PFAFF, EUGENE BRAUNWALD
Journal: Circulation (1961)

The instrumentation and clinical applications, in this laboratory, of Clark's sodium ascorbate dilution technic are described. With this method the sensing device, a platinum electrode, is introduced directly into the blood stream, and a reducing agent, sodium ascorbate, is used as the indicator. Time-concentration curves may be obtained without the withdrawal of blood. Observations in 90 patients have indicated that the contours of the dilution curves are essentially identical to indocyanine-green dye-dilution curves, except for diminished peripheral recirculation peaks. The ascorbate-dilution technic has been found of particular value when the sensing electrode is incorporated into a cardiac catheter. This method permits injection and sampling of the indicator from the central circulation and greatly facilitates the study of circulatory shunts and of valvular regurgitation.
VISION AND COLOR PERCEPTION FOR RAILWAY SERVICE.
Authors: WM. C. BANE
Journal: JAMA (1900)

At the last meeting Dr. Pritchard favored the Academy with an article on the "Physical Examination of Railway Men," which included the test for vision and color perception. In the discussion that followed, many valuable points were brought out, and in considering the vision and color perception for railway service I must necessarily repeat some of the facts mentioned at that meeting. For efficient service it is essential that those who give and receive signals have normal vision and perfect color perception. At the present time no uniform standard exists among the various roads that require applicants to pass an examination previous to entering their service. Their standard varies from a high to a low one. This is not as it should be, for there ought to be a uniformly high standard for physical examination, vision, and also some uniformity as to the colored yarns, flags and lights used. The
Physicians and Disaster Preparedness
Authors: James O. Mason
Journal: JAMA (1992)

<h3>To the Editor.</h3> —I was delighted to see the focus on national planning for medical response to major disasters and emergencies.<sup>1</sup>However, in reading the article, I was disappointed to discover that Drs Pretto and Safar failed to recognize the important distinction between traditional, everyday emergency medical services (EMS) response and catastrophic mass casualty response. In fact, they completely ignored the National Disaster Medical System (NDMS), its current operational plans and arrangements, and its rapidly increasing medical response capabilities. Although EMS deal with everyday emergencies, a disaster, by definition, is an occurrence that overwhelms available personnel and other resources. To assume that concentrations of personnel and technology will occur rapidly following an incident producing tens of thousands of seriously injured or ill victims is impractical and unrealistic and creates false expections. Given the vast geographic area of our nation, the multiple major metropolitan concentrations of our population, the wide
Foundation year for newly qualified doctors
Authors: Nicholas J Matheson, Alex Burns, Katherine Henderson
Journal: BMJ (2005)

EDITOR—In his article on the new UK foundation programme, Hays says that assessment willfocus on practical aspects of medical work rather than examinations.1 An examination already exists, however, that is explicitly set to correspond with thelevel of knowledge expected of a doctor at the end of foundation year 1.

This is the Professional and Linguistic Assessment Board Test (PLAB), administered by the General …
Minimal and optimal peritoneal Kt/V targets: Results of an anuric peritoneal dialysis patient's survival analysis
Authors: Wai-Kei Lo, Sing-Leung Lui, Tak-Mao Chan, Fu-Keung Li, Man-Fai Lam, Kai-Chung Tse, Sydney Chi-Wai Tang, Cindy Bo-Ying Choy, Kar-Neng Lai
Journal: Kidney International (2005)
Ca(2+)-transporting ATPase, phospholamban, and calsequestrin levels in nonfailing and failing human myocardium.
Authors: M A Movsesian, M Karimi, K Green, L R Jones
Journal: Circulation (1994)

BACKGROUND Observations of abnormalities in the diastolic components of intracellular Ca2+ transients in failing human left ventricular myocardium have raised the possibility that reductions in the level or function of sarcoplasmic reticulum proteins involved in Ca2+ transport contribute to the pathophysiology of dilated cardiomyopathy in humans. Functional assays, however, have revealed no differences in ATP-dependent Ca2+ transport or its modulation by phospholamban in sarcoplasmic reticulum-enriched microsomes prepared from nonfailing and failing human left ventricular myocardium. The purpose of the present study was to quantify protein levels of Ca(2+)-transporting ATPase, phospholamban, and calsequestrin directly in nonfailing and failing human left ventricular myocardium. METHOD AND RESULTS Total protein extracts were prepared from nonfailing left ventricular myocardium from the hearts of unmatched organ donors with normal left ventricular contractility (n = 6) and from failing left ventricular myocardium from the excised hearts of transplant recipients with class IV heart failure resulting from idiopathic dilated cardiomyopathy (n = 6). Ca(2+)-transporting ATPase, phospholamban, and calsequestrin contents were determined by quantitative immunoblotting with monoclonal and affinity-purified polyclonal antibodies. The levels of the three proteins were identical in nonfailing and failing human left ventricular myocardium. CONCLUSIONS These results indicate that protein levels of Ca(2+)-transporting ATPase, phospholamban, and calsequestrin are not diminished in failing human left ventricular myocardium and that downregulation of the Ca(2+)-transporting ATPase and phospholamban is not part of the molecular pathophysiology of dilated cardiomyopathy in humans.
At least 25% of elderly residents of German nursing homes are addicted to psychotropic drugs, report claims
Authors: N. Stafford
Journal: BMJ (2010)

Germans continue to be among the biggest consumers of alcohol in the world, while the percentage of Germans who smoke cigarettes is continuing a downward trend, says a recently released report on addiction that also covers prescription and over the counter drugs, illegal drugs, and gambling.

The report, released by the German Centre for Addiction Issues (DHS), painted an especially alarming picture of addiction to prescription drugs among elderly people, estimating that “at least 25%” of nursing home residents over the age of 70 are addicted to psychotropic drugs, with women particularly at risk.

Raphael Gassmann, director of the DHS’s addiction centre, in Hamm, North Rhine-Westphalia, told the BMJ that although it is normal for people to need less sleep as they age, many elderly people grow concerned and consult their doctors.

“Sometimes they ask the doctor for …
The long and the short of aberrant ciliogenesis in Huntington disease
Authors: Jeh-Ping Liu, Scott O. Zeitlin
Journal: Journal of Clinical Investigation (2011)

Huntington disease (HD) is a dominantly inherited neurodegenerative disorder that is caused by a mutant huntingtin (HTT) gene encoding a version of the Htt protein with an expanded polyglutamine stretch. Although the HTT gene was discovered more than 18 years ago, the functions of normal Htt and the mechanisms by which mutant Htt causes disease are not well defined. In this issue of the JCI, Keryer et al. uncovered a novel function for normal Htt in ciliogenesis and report that mutant Htt causes hypermorphic ciliogenesis and ciliary dysfunction. These observations suggest that it is now critical to understand the extent to which ciliary dysfunction contributes to the different symptoms of HD and to determine whether therapeutic strategies designed to normalize ciliary function can ameliorate the disease.
Why are children referred for circumcision?
Authors: N Williams, J Chell, L Kapila
Journal: BMJ (1993)

Most of the 30000 circumcisions performed in the United Kingdom each year are done on boys aged under 15.1 Controversy exists over whether all these procedures are necessary or justified.' 2 Gairdner reported that the foreskin develops entirely normally and free of problems in all but 1% of boys by the age of 15.2 Rickwood and Walker, however, suggest that up to 6% of boys in Mersey region are circumcised by the age of 15.1 This highlights a discrepancy in the expected and observed rates of circumcision.To address this we audited all referrals from general practitioners for penile problems to this unit.
Introduction to power-frequency electric and magnetic fields.
Authors: W T Kaune
Journal: Environmental Health Perspectives (1993)

This paper introduces the reader to electric and magnetic fields, particularly those fields produced by electric power systems and other sources using frequencies in the power-frequency range. Electric fields are produced by electric charges; a magnetic field also is produced if these charges are in motion. Electric fields exert forces on other charges; if in motion, these charges will experience magnetic forces. Power-frequency electric and magnetic fields induce electric currents in conducting bodies such as living organisms. The current density vector is used to describe the distribution of current within a body. The surface of the human body is an excellent shield for power-frequency electric fields, but power-frequency magnetic fields penetrate without significant attenuation; the electric fields induced inside the body by either exposure are comparable in magnitude. Electric fields induced inside a human by most environmental electric and magnetic fields appear to be small in magnitude compared to levels naturally occurring in living tissues. Detection of such fields thus would seem to require the existence of unknown biological mechanisms. Complete characterization of a power-frequency field requires measurement of the magnitudes and electrical phases of the fundamental and harmonic amplitudes of its three vector components. Most available instrumentation measures only a small subset, or some weighted average, of these quantities. Hand-held survey meters have been used widely to measure power-frequency electric and magnetic fields. Automated data-acquisition systems have come into use more recently to make electric- and magnetic-field recordings, covering periods of hours to days, in residences and other environments.(ABSTRACT TRUNCATED AT 250 WORDS)