tbuckley/cabot-search huggingface dataset:
Pathology service run jointly with Serco is "in turmoil," claims report
Authors: N. Hawkes
Journal: BMJ (2012)

A joint venture in pathology services between two London trusts and the private sector company Serco has yet to turn a profit, and its management has admitted that it had underestimated the task and was now trying to recover from a poor start.

GSTS Pathology was set up as a partnership between Serco and Guy’s and St Thomas’s NHS Foundation Trust in 2009 after a review of pathology services carried out in 2006 by the Labour peer Patrick Carter had recommended that savings could be made if pathology services were delivered by specialised service providers.1 King’s College Hospital joined in 2010. In 2011 the joint venture lost £5.9m (€7.4m; $9.5m) on a turnover of £85m.

A …
Cloning of the mammalian type II iodothyronine deiodinase. A selenoprotein differentially expressed and regulated in human and rat brain and other tissues.
Authors: W Croteau, J C Davey, V A Galton, D L St Germain
Journal: Journal of Clinical Investigation (1996)

The deiodination of thyroid hormones in extrathyroidal tissues plays an important role in modulating thyroid hormone action. The type II deiodinase (DII) converts thyroxine to the active hormone 3,5,3'-triiodothyronine, and in the rat is expressed in the brain, pituitary gland, and brown adipose tissue (BAT). Complementary DNAs (cDNAs) for the types I and III deiodinases (DI and DIII, respectively) have been isolated and shown to code for selenoproteins. However, information concerning the structure of the mammalian DII remains limited, and the pattern of its expression in human tissues is undefined. We report herein the identification and characterization of rat and human DII cDNAs. Both code for selenoproteins and exhibit limited regions of homology with the DI and DIII. In the rat pituitary and BAT, DII mRNA levels are altered more than 10-fold by changes in the thyroid hormone status of the animal. Northern analysis of RNA derived from human tissues reveals expression of DII transcripts in heart, skeletal muscle, placenta, fetal brain, and several regions of the adult brain. These studies demonstrate that: (a) the rat and human DII are selenoproteins, (b) DII expression in the rat is regulated, at least in part, at the pretranslational level in some tissues, and (c) DII is likely to be of considerable physiologic importance in thyroid hormone economy in the human fetus and adult.
Cigarette Smoking, Weight Gain, and Coronary Mortality
Authors: Janet E. Fulton, Richard B. Shekelle
Journal: Circulation (1997)

Background Prospective studies of overweight and coronary heart disease (CHD) have presented inconsistent findings. Previous inconsistencies may be explained by the modifying effect of cigarette smoking on the association between weight gain and coronary mortality. Methods and Results We prospectively studied 1531 men 40 to 59 years of age who were employed at the Hawthorne Works of the Western Electric Company in Chicago, Ill. Information collected at the initial examination in 1958 included recalled weight at age 20, present weight, height, smoking status, and other CHD risk factors. Vital status was known for all men on the 25th anniversary: 257 CHD deaths occurred over 31 644 person-years of experience. Cox regression analysis was used to investigate risk of coronary mortality associated with change in body mass index (ΔBMI) and its modification by smoking status after adjustment for age, major organ system disease, family history of CHD, and BMI at age 20. Adjustment was not performed for blood pressure or serum total cholesterol because these are intervening variables. ΔBMI was positively associated with risk of coronary mortality in never-smokers but not in current-smokers ( P for interaction=.088). For never-smokers with ΔBMI classified as stable, low gain, moderate gain, or high gain, adjusted relative risks of coronary mortality were 1.00, 1.75, 1.75, and 3.07, respectively ( P for trend=.010). For current-smokers, the respective adjusted relative risks were 1.00, 0.78, 1.05, and 1.03 ( P for trend=.344). Conclusions These results support the hypothesis that cigarette smoking modifies the association between weight gain and coronary mortality. Future investigations of weight gain and coronary mortality should account for the modifying effect of cigarette smoking.
Some incorrect implications of the fullaccess hypothesis
Authors: Frederick J. Newmeyer
Journal: Behavioral and Brain Sciences (1996)

Abstract If Epstein et al. are right that adult second language learners have full access to UG, then all of the following should be true: adults should be able to consciously transform their I-Language; adults should be able to transform pidgins into Creoles; adults should be as likely as children to restructure their grammars on the basis of “functional” pressure. All the foregoing are false, however, which seriously calls into question the correctness of their hypothesis.
Growth Pattern and Dietary Intake of Children with Chronic Renal Insufficiency
Authors: P. R. Betts, G. Magrath
Journal: BMJ (1974)

The growth pattern and dietary intake of 33 children with varying degrees of renal insufficiency has been investigated. The development of impaired renal function in infancy has a more deleterious effect on linear growth than has its onset in later years. A reduction in growth velocity may occur once the glomerular filtration rate falls below 25 ml/min/1.73m(2). There was a significant reduction of the energy, protein, and vitamin D intakes of children with renal insufficiency compared with those recommended for their age, and of energy intake compared with that of normal children of their own height. Reduced growth velocity occurred when energy intake fell below 80% of that recommended. The reduction in the intake of energy and nutrients in these children may in part be responsible for their growth retardation.
Dietary vitamin D is essential for normal insulin secretion from the perfused rat pancreas.
Authors: S Kadowaki, A W Norman
Journal: Journal of Clinical Investigation (1984)

We have reported previously that arginine-induced insulin secretion was impaired in the vitamin D-deficient rat pancreas, and that it was improved by dietary vitamin D repletion (Norman, A. W., B. J. Frankel, A. M. Heldt, and G. M. Grodsky, 1980, Science [Wash. DC]. 209:823-825). In this study, we evaluate in the perfused rat pancreas system whether the effects of vitamin D and its metabolites on insulin secretion are direct in action on the pancreas and limited to the secretagogue arginine, or whether they are secondary to the hypocalcemia or reduced caloric and calcium intake associated with vitamin D deficiency. In an experiment where vitamin D-replete (+D) rats were pair-fed to D-deficient (-D) rats fed ad lib., the secretion of insulin in response to arginine infusion in the +D perfused rat pancreas was threefold higher than in the -D control. In a second experiment, the serum calcium level was elevated from the characteristic hypocalcemic level of -D rats (4.9 +/- 0.1 mg/dl) to a normal calcemic level (10.0 +/- 0.3 mg/dl) by feeding the rats a -D diet with dietary calcium levels ranging from 0.4 to 4%. In these -D rats, the pancreatic perfusion study with the secretagogue arginine showed a similar blunted insulin secretion response in all groups in spite of the significant differences of serum calcium levels. In a third experiment, insulin secretion in response to the separate administration of arginine (10 mM), glucose (16.9 mM), and tolbutamide (0.37 mM) was found to be significantly higher in pair-fed, normocalcemic +D rats than in -D rats with normal calcium levels. These results indicate that vitamin D or its metabolites are essential for normal insulin secretion and that the dietary intake of calcium and the resulting serum calcium levels play a lesser role than vitamin D availability in mediating insulin secretion.
The pacing stress test: Thallium-201 myocardial imaging after atrial pacing. Diagnostic value in detecting coronary artery disease compared with exercise testing
Authors: Gary V. Heller, Julian M. Aroesty, J. Anthony Parker, Raymond G. McKay, Kenneth J. Silverman, Ann V. Als, Patricia C. Come, Gerald M. Kolodny, William Grossman
Journal: Journal of the American College of Cardiology (1984)
Butyrate downregulates alpha2beta1 integrin: a possible role in the induction of apoptosis in colorectal cancer cell lines
Authors: A Buda
Journal: Gut (2003)

Integrins mediate cell matrix adhesion and regulate cell growth and survival. In colonic epithelial cells, alpha(2)beta(1) integrin controls glandular differentiation and proliferation. Butyrate stimulates differentiation and induces apoptosis in vitro.We investigated whether butyrate induction of apoptosis was associated with perturbation of integrin mediated cell matrix adhesion.Three colonic cancer cell lines (SW1222, SW620, LS174T) were studied. Adhesion to extracellular matrix proteins, expression of alpha(2)beta(1) integrin, and apoptosis were studied in adherent cells after treatment with 4 mM butyrate.Butyrate decreased the attachment to type I collagen in SW620 cells and type I and IV collagen in LS174T cells. The decreased cell attachment was associated with downregulation of alpha(2)beta(1) integrin and increased apoptosis in adherent cells. No changes in alpha(2)beta(1) expression or matrix adhesion were seen in SW1222 cells, which were also found to be less sensitive to butyrate induction of apoptosis. Downregulation of alpha(2)beta(1) integrin preceded the detection of apoptosis.Apoptosis induced by butyrate is associated with downregulation of expression and functional activity of alpha(2)beta(1) integrin. Perturbation of cell matrix adhesion may be a novel mechanism by which butyrate induces apoptosis in colorectal cancer cells.
Antibody Production in Man: In Vitro Synthesis and Clinical Implications
Authors: Lawrence D. Grouse
Journal: JAMA (1980)

This volume comprises the proceedings of an immunology workshop held in March 1978 in Utrecht, Holland. The workshop arose in response to the need to exchange, analyze, and criticize research findings in a rapidly advancing area of immunology—the induction and regulation of human B-cell function. Methodology such as the mitogen-induced and antigen-specific plaque-forming cell assays and discoveries such as the identification of subpopulations of human lymphoid cells that regulate B-cell function are extensively described in this volume. The book format of "rapid manuscript production" is the same as is commonly employed in many current scientific journals. The articles are organized as scientific communications with the usual introduction, methods, results, and discussion sections. This format facilitates the rapid publication of this work and allows the reader to evaluate critically the work by presenting the techniques and data as well as the conclusions. Also, helpful for a critical evaluation are the lucid
Health Consequences of Religious and Philosophical Exemptions From Immunization Laws
Authors: Daniel A. Salmon, Michael Haber, Eugene J. Gangarosa, Lynelle Phillips, Natalie J. Smith, Robert T. Chen
Journal: JAMA (1999)

ContextAll US states require proof of immunization for school entry. Exemptions are generally offered for medical, religious, or philosophical reasons, but the health consequences of claiming such exemptions are poorly documented.ObjectivesTo quantify the risk of contracting measles among individuals claiming religious and/or philosophical exemptions from immunization (exemptors) compared with vaccinated persons, and to examine the risk that exemptors pose to the nonexempt population.Design, Setting, and ParticipantsPopulation-based, retrospective cohort study of data from 1985 through 1992, collected by the Measles Surveillance System of the Centers for Disease Control and Prevention, as well as from annual state immunization program reports on prevalence of exemptors and vaccination coverage. The study group was restricted to individuals aged 5 to 19 years. To empirically determine and quantify community risk, a mathematical model was developed that examines the spread of measles through communities with varying proportions of exemptors and vaccinated children.Main Outcome MeasuresRelative risk of contracting measles for exemptors vs vaccinated individuals based on cohort study data. Community risk of contracting measles derived from a mathematical model.ResultsOn average, exemptors were 35 times more likely to contract measles than were vaccinated persons (95% confidence interval, 34-37). Relative risk varied by age and year. Comparing the incidence among exemptors with that among vaccinated children and adolescents during the years 1985-1992 indicated that the 1989-1991 measles resurgence may have occurred 1 year earlier among exemptors. Mapping of exemptors by county in California indicated that exempt populations tended to be clustered in certain geographic regions. Depending on assumptions of the model about the degree of mixing between exemptors and nonexemptors, an increase or decrease in the number of exemptors would affect the incidence of measles in nonexempt populations. If the number of exemptors doubled, the incidence of measles infection in nonexempt individuals would increase by 5.5%, 18.6%, and 30.8%, respectively, for intergroup mixing ratios of 20%, 40%, and 60%.ConclusionsThese data suggest the need for systematic review of vaccine-preventable incidents to examine the effect of exemptors, increased surveillance of the number of exemptors and cases among them, and research to determine the reasons why individuals claim exemptions.
Dental Caries, Vitamin D, and Mineral Deficiencies
Authors: G. F. Taylor, C. D. M. Day
Journal: BMJ (1939)

4-5-6-7-8-9-10England and 61.4 12.9 5.6 4.2 3.3 2.8 2.4 1.9 1.6 1.4 Wales Germany .. 90.0 9.0 4.5 3.2 2.6 2.2 2.1 1.9 1.6 1.5 TABLE 111.-DeathRates fromn Selected Causes of Death at Different Ages in England and Wales for the Years 1932-5 expressed as Percentages of those in Germany.(Germany = 100 per cent.)
Treatment of Vertebral Hemangioma by Intralesional Injection of Absolute Ethanol
Authors: John D. Heiss, John L. Doppman, Edward H. Oldfield
Journal: New England Journal of Medicine (1996)

To the Editor: Two years ago (Aug. 25, 1994, issue),1 we reported on two patients who had relief of spinal cord compression after the direct injection of ethanol into a vertebral hemangioma. The im...
Perils, Pitfalls, and Possibilities in Talking About Medical Risk
Authors: Sidney T. Bogardus, Jr
Journal: JAMA (1999)

Virtually every course of medical action is associated with some adverse risk to the patient. Discussing these risks with patients is a fundamental duty of physicians both to fulfill a role as trusted adviser and to promote the ethical principle of autonomy (particularly as embodied in the doctrine of informed consent). Discussing medical risk is a difficult task to accomplish appropriately. Challenges stem from gaps in the physician's knowledge about pertinent risks, uncertainty about how much and what kind of information to communicate, and difficulties in communicating risk information in a format that is clearly understood by most patients. For example, a discussion of the risk of undergoing a procedure should be accompanied by a discussion of the risk of not undergoing a procedure. This article describes basic characteristics of risk information, outlines major challenges in communicating risk information, and suggests several ways to communicate risk information to patients in an understandable format. Ultimately, a combination of formats (eg, qualitative, quantitative, and graphic) may best accommodate the widely varying needs, preferences, and abilities of patients. Such communication will help the physician accomplish the fundamental duty of teaching the patient the information necessary to make an informed and appropriate decision.
END-RESULTS OF OPERATION FOR CLAW-FOOT
Authors: ALAN DE FOREST SMITH
Journal: JAMA (1925)

In the course of an investigation to determine end-results in conditions treated at the New York Ortho paedic Dispensary and Hospital, a study was made of patients on whom an operation for claw-foot was performed. The operation, which consists in the transference of the extensor digitorum longus and extensor hallucis longus tendons, was devised by Hibbs and was first described by him in 1919.<sup>1</sup>All such patients who were operated on from 1916 to 1921, and who responded to an appeal to return for examination, were included. In all, there were 124 patients, on sixty-two of whom the procedure was carried out on both feet, making in all 186 operations. The work was that of thirteen different surgeons. The cases were seen at an interval of from two to six years after operation. The original condition, for which the procedure was carried out, was claw-foot deformity with hammer-toes, impaired
Diagnostic Value of Fluorescent Antibodies
Authors: D. W. Wylie, M. G. C. Boatman
Journal: BMJ (1968)

<h3>Abstract</h3> In this article we advance a cutting-edge methodology for the study of the dynamics of plant movements of nutation. Our approach, unlike customary kinematic analyses of shape, period, or amplitude, is based on three typical signatures of adaptively controlled processes and motions, as reported in the biological and behavioral dynamics literature: harmonicity, predictability, and complexity. We illustrate the application of a dynamical methodology to the bending movements of shoots of common beans (<i>Phaseolus vulgaris</i> L.) in two conditions: with and without a support to climb onto. The results herewith reported support the hypothesis that patterns of nutation are influenced by the presence of a support to climb in their vicinity. The methodology is in principle applicable to a whole range of plant movements.
DIABETES AND PERNICIOUS ANEMIA
Authors: HOWARD F. ROOT
Journal: JAMA (1931)

The combination of pernicious anemia and diabetes mellitus has been repeatedly described as extremely rare. The first case was reported in 1910 by Parkinson. 1 Within the last two years, nine instances have occurred at the New England Deaconess Hospital, and I have been able to discover a total of forty-eight cases, including unpublished records of patients given to me by other physicians and cases recorded in the literature. The increased interest of physicians inspired by the recent discoveries in the treatment of the two diseases has stimulated diagnosis, but another factor is the increase in the duration of life resulting from improvement in treatment, which affords more opportunity for the combination to occur.  The relative frequency of the two diseases is indicated in tables 1 and 2 by the statistics of Goudsmit 2 for Holland and by statistics from the Metropolitan Life Insurance Company (New York), prepared by Mr.
Naftidrofuryl for intermittent claudication: a double-blind controlled trial.
Authors: C V Ruckley, M J Callam, C M Ferrington, R J Prescott
Journal: BMJ (1978)

Patients who receive a kidney transplant commonly experience failure of their allograft. Transplant failure often comes with complex management decisions, such as when and how to wean immunosuppression and start the transition to a second transplant or to dialysis. These decisions are made in the context of important concerns about competing risks, including sensitization and infection. Unfortunately, the management of the failed allograft is, at present, guided by relatively poor-quality data and, as a result, practice patterns are variable and suboptimal given that patients with failed allografts experience excess morbidity and mortality compared with their transplant-naive counterparts. In this review, we summarize the management strategies through the often-precarious transition from transplant to dialysis, highlighting the paucity of data and the critical gaps in our knowledge that are necessary to inform the optimal care of the patient with a failing kidney transplant.
Sudanese doctor describes "hell on earth" in Darfur
Authors: P. Moszynski
Journal: BMJ (2008)

Halima Bashir has little sympathy for her namesake, Field Marshal Omer el Bashir, who was last week indicted by the International Criminal Court on 10 counts of genocide, war crimes, and crimes against humanity. She hopes that Sudan’s president “suffers the same fate as Saddam Hussein,” she said, adding: “Here I am speaking not as a doctor but as a victim.”

Dr Bashir knows better than almost anyone the horror of the crimes committed in Darfur. She not only witnessed them first hand and treated the survivors but was arrested and gang raped by members of the security forces for speaking out against them.

She has now found refuge in London and the courage to write about her ordeal in her new book, Tears of the Desert , in which …
Osteomyelitis in Hemodialysis Patients
Authors: ARTHUR LEONARD
Journal: Annals of Internal Medicine (1973)

Five patients receiving regular hemodialysis developed osteomyelitis. Rib and thoracic vertebral column were the most common sites of involvement. The diagnosis was made ante mortem in four and discovered at autopsy in one patient. Osteomyelitis masqueraded as podagra, bacterial endocarditis, renal osteodystrophy, and fever of unknown origin. Three patients were considered cured, but only two lived. Surgical intervention was necessary to establish the diagnosis and to definitively treat four patients. Repeated access to the circulation, particularly when associated with indwelling cannulas, is the most important determinant of infection. Diabetes mellitus, chronic pulmonary disease, and adrenocorticosteroid therapy may be contributory causes.