tbuckley/cabot-search huggingface dataset:
Pressure mounts over European Working Time Directive
Authors: Tony Sheldon
Journal: BMJ (2004)

Pressure is mounting across the European Union for changes to theEuropean Working Time Directive before the 1 August deadline requiring junior doctors to work an average 58 hour week.

A United Kingdom House of Lords committee report warned last week of a potential staffing crisis equivalent to losing 3700 junior doctors.

The Dutch government is calling for changes “before the summer” if it is to avoid spending €100m (£66m; $122m) on extra staff. Germany has said that the directive could mean increasing doctors' numbers by nearly a quarter, costing €1.75bn.

These views have been fed into the European Commission's “consultative review” of the directive, which closed on 31 March.

Concerns centre on two rulings by the European Court of Justice, covering resident on-call duties and compensatory rest periods. In 2000 the Sindicato de Medicos de Asistencia Publica judgment …
1090-222 A randomized study of prophylactic catheter ablation in high-risk children with asymptomatic Wolff-Parkinson-White syndrome
Authors: Carlo Pappone, Vincenzo Santinelli, Francesco Manguso, Gabriele Vicedomini, Salvatore Rosanio, Simone Gulletta, Patrizio Mazzone, Giuseppe Augelio
Journal: Journal of the American College of Cardiology (2004)
Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality
Authors: A. Nicoll, M. Ramsay
Journal: BMJ (1995)

Ed Kathleen R Stratton, Cynthia J Howe, Richard B Johnston National Academy Press, $49.95 ISBN 0 309 04895 8

Together with a companion volume, this book reviews possible causal relations between childhood vaccines and adverse effects. The reviews, undertaken by committees established by the United States Institute of Medicine, considered published reports (including those in non-English language journals) and routine surveillance data from the United States, and both volumes contain extensive references.

The earlier volume reviewed the evidence on pertussis and rubella vaccines. This new volume considers other vaccines regularly given to children: diphtheria, tetanus, measles, mumps, polio, hepatitis …
Time and the Nervous System
Authors: Sidney Schulman
Journal: JAMA (1989)

This small book by a distinguished British neurologist is an outcome of his years of reflection on disorders of human cortical function, and on an insight that came to him one day with such force and suddenness that he recalls the precise circumstances—driving his car near Alton in Hampshire on March 18, 1959. The insight was that "the brain is the place or mechanism or medium by which time is converted into space and space into time." The book amounts to a collection of short discourses on a diversity of topics ranging from the elementary anatomy of the nerve cell, the general plan of the central nervous system, and clinical disorders of orientation in space and time to the conflicting notions of time held by various physicists and philosophers and the evolution of cosmologies from prehistory to the present. The treatment of the medical and neurobiological topics is cursory, generally
A Phase II Study of Tg4010 (Mva-Muc1-Il2) in Association with Chemotherapy in Patients with Stage III/IV Non-small Cell Lung Cancer
Authors: Rodryg Ramlau, Elisabeth Quoix, Janusz Rolski, Miklos Pless, Herve Lena, Eric Lévy, Maciej Krzakowski, Dagmar Hess, Eric Tartour, Marie-Pierre Chenard, Jean-Marc Limacher, Nadine Bizouarne, Bruce Acres, Céline Halluard, Thierry Velu
Journal: Journal of Thoracic Oncology (2008)
Induction by Interleukin-2 of Oligoclonal Expansion of Cultured Tumor-Infiltrating Lymphocytes
Authors: A. J. Fishleder, J. H. Finke, R. Tubbs, R. M. Bukowski
Journal: JNCI Journal of the National Cancer Institute (1990)

To better understand the modulatory effects of interleukin-2 (IL-2) on lymphocyte proliferation, we examined the clonality of the in vitro T-cell response by Southern blot hybridization. Tumor-infiltrating lymphocytes (TILs) grown in the presence of IL-2 for 15–26 days had detectable T-cell receptor beta-chain gene rearrangements, which indicated oligoclonal enhancement in culture in four of nine TIL samples. In contrast, none of 11 uncultured TIL samples had detectable gene rearrangements. Lack of detection in at least three of the five negative, cultured TIL samples could be explained by increased numbers of natural killer cells. We hypothesize that the oligoclonal expansion noted results from the enhanced response of immune-primed T cells to IL-2. [J Natl Cancer Inst 82: 124–128, 1990]
Neutrophil-Mediated Degradation of Lung Proteoglycans
Authors: DAISY K. Y. SHUM, STANLEY C. H. CHAN, MARY S. M. IP
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Neutrophil-mediated degradation of bronchial matrix has been proposed as a pathogenetic factor in bronchiectasis. We hypothesize that neutrophils, found in abundance in the bronchial lumens of patients with bronchiectasis, are capable of degrading lung matrix proteoglycans and that proinflammatory mediators in bronchial secretions of these patients can enhance the degradative action of neutrophils. We used rat bronchoalveolar proteoglycans entrapped in polyacrylamide gel beads as a substrate for test incubations with neutrophils from healthy volunteers and sputum sol from patients with idiopathic bronchiectasis. Coincubations with specimens of sputum sol and neutrophils showed proteoglycan degradation indices (PDIs) in excess of the sum of indices due to incubation with either heat-inactivated sputum sol or heat-inactivated neutrophils, suggesting sputum stimulation of the neutrophil response. Mediation of this stimulation by tumor necrosis factor (TNF)- α was suggested because (1) indices for the coincubations correlated with sputum levels of TNF- α and (2) an anti–TNF- α antibody completely attenuated the sputum-stimulated effect. Furthermore, recombinant human TNF- α required accompanying sputum sol to exert an enhancing effect on neutrophil-mediated proteoglycan degradation. Because neutrophil-mediated proteoglycan degradation in the coincubations was inhibited largely (90%) by Eglin C and much less so (8% to 20%) by ethylenediamine tetraacetic acid, we conclude that serine proteases secreted by neutrophils were mainly responsible for degradation of proteoglycans in the model matrix and that the secretion was stimulated by TNF- α in the presence of cofactors in the bronchial secretions of patients with bronchiectasis.
Prevalence of cartilage lesions in foot joints: a test of the concept of limited and progressive lesions.
Authors: H R Youngman, F Cooper, P Byers
Journal: Annals of the Rheumatic Diseases (1987)

Lesions in the articular cartilage of the joints of the first ray of feet amputated from 54 patients in the age range 10-79 years have been categorised by site, size, and stage of development. The large number of small lesions in early stages of development, appearing from an early age, and the few lesions with extensive bone exposure, occurring only in later years, lend corroboration to the concept of limited and progressive lesions, as established for the hip joint.
Shifts in opportunities for doctors in training
Authors: D M Roberton
Journal: BMJ (1998)

The health of an individual represents a continuum of events. Therefore health care requires continuity of assessment, planning, and treatment. Is it necessary to have most of the medical care provided by one doctor, or can adequate care be provided by a variety of doctors for each health event? Can continuity of care in hospitals be met by trainee doctors working shifts, and can shift work and reduced hours meet training requirements?

These are important questions for teaching hospitals. In most countries where early postgraduate medical training takes place in general hospitals three needs are evident: to define appropriate training requirements for progression to higher levels of practice; to provide the maximum effectiveness of care for the lowest possible cost; and to provide reasonable hours of work for staff in training.1-4

In medicine skills and knowledge are traditionally gained by apprenticeship and experience. 4 5 …
Quantitative Assessment of Myocardial Viability After Infarction by Dobutamine Magnetic Resonance Tagging
Authors: Gennady Geskin, Christopher M. Kramer, Walter J. Rogers, Therese M. Theobald, Diana Pakstis, Yong-Lin Hu, Nathaniel Reichek
Journal: Circulation (1998)

Background —The assessment of return of function within dysfunctional myocardium after acute myocardial infarction (MI) using contractile reserve has been primarily qualitative. Magnetic resonance (MR) myocardial tagging is a novel noninvasive method that measures intramyocardial function. We hypothesized that MR tagging could be used to quantify the intramyocardial response to low-dose dobutamine and relate this response to return of function in patients after first MI. Methods and Results —Twenty patients with a first reperfused MI (age, 53±12 years; 16 male; 11 inferior MIs) were studied. Patients underwent breath-hold MR-tagged short-axis imaging on day 4±2 after MI at baseline and during dobutamine infusion at 5 and 10 μg · kg −1 · min −1 . At 8±1 weeks after MI, patients returned for a follow-up MR tagging study without dobutamine. Quantification of percent intramyocardial circumferential segment shortening (%S) was performed. Low-dose dobutamine MRI was well tolerated. Overall, mean %S was 15±11% at baseline (n=227 segments), increased to 16±10% at 5 μg · kg −1 · min −1 dobutamine ( P =NS), 21±10% at peak ( P &lt;0.0001 versus baseline and 5 μg · kg −1 · min −1 ), and 18±10% at 8 weeks ( P &lt;0.004 versus baseline and peak). The increase in %S with peak dobutamine was greater in dysfunctional myocardium (103 segments, +9±10%) than in normal tissue (124 segments, +4±12%, P &lt;0.0001). In dysfunctional regions, %S also increased from 6±7% at baseline to 14±10% at 8 weeks after MI ( P &lt;0.0001). In dysfunctional regions that responded normally to peak dobutamine (≥5% increase in %S), the increase in %S from baseline to 8 weeks after MI (+9±9%) was greater than in those regions that did not respond normally (+5±9%, P &lt;0.04). Midmyocardial and subepicardial response to dobutamine were predictive of functional recovery, but the subendocardial response was not. Conclusions —The response of intramyocardial function to low-dose dobutamine after reperfused MI can be quantified with MR tagging. Dysfunctional tissue after MI demonstrates a larger contractile response to dobutamine than normal myocardium. A normal increase in shortening elicited by dobutamine within dysfunctional midwall and subepicardium predicts greater functional recovery at 8 weeks after MI, but the response within the subendocardium is not predictive.
Invasive aspergillosis in patients with severe alcoholic hepatitis
Authors: Thierry Gustot, Evelyne Maillart, Massimo Bocci, Rudy Surin, Eric Trépo, Delphine Degré, Valerio Lucidi, Fabio Silvio Taccone, Marie-Luce Delforge, Jean-Louis Vincent, Vincent Donckier, Frédérique Jacobs, Christophe Moreno
Journal: Journal of Hepatology (2013)
Pharmacogenetics; heredity and the response to drugs.
Authors: John C. Ballin
Journal: JAMA (1963)

The well-known variations in drug response in a heterogeneous population such as man occur because of the many genetic and environmental factors which constitute individuality. Put another way, each person's genetic makeup determines, in large measure, how he reacts to environmental factors— including drugs. As a timely example, it has been estimated that only about 20% of babies born to women who had taken thalidomide during the critical fourth to eighth weeks of pregnancy developed limb malformations. It thus seems logical to hypothesize that the teratogenic effect of the drug could only have developed in genetically susceptible women. While not discussing thalidomide per se, this book attempts to offer explanations for similar drug-response variations, both in man and in lower animals. Written by a pharmacologist, it brings together under one cover a wealth of widely-scattered information from biochemistry, pharmacology, genetics, and medicine dealing with drug response. Included are chapters on
Disseminated Intravascular Coagulation (DIC) after Endoscopic Injection Sclerotherapy with Ethanolamine Oleate
Authors: S. V. Bellary, P. Isaacs
Journal: Endoscopy (1990)

See also: Anaphylactic Reaction to Ethanolamine Oleate Injection in Sclerotherapy of Esophageal VaricesEndoscopy 1989; 21(01): 50-50DOI: 10.1055/s-2007-1012897
Hugh Hunter Morrison
Authors: C. Morrison
Journal: BMJ (2004)

Former general practitioner Stanley, County Durham (b Prestwick, Ayrshire, 1919; q Glasgow 1943), died from prostate cancer on 18 January 2003.​2003.




Figure 1




During the second world war Hugh served with the Royal Naval Volunteer Reserve in Simonstown, South Africa, and Kristiansand, Norway—just after German withdrawal—supplying the local hospital with its first antibiotics. He was then involved with the D Day landings. He later settled into general practice in Port Glasgow before moving to Stanley, County Durham, in 1948. His beloved Austin Healey Sprite is now being restored in his memory. He leaves a wife, Nancy, and three children.
A novel porcine acellular dermal matrix scaffold used in periodontal regeneration
Authors: Jing Guo, Hui Chen, Ying Wang, Cheng-Bo Cao, Guo-Qiang Guan
Journal: International Journal of Oral Science (2013)

Regeneration of periodontal tissue is the most promising method for restoring periodontal structures. To find a suitable bioactive three-dimensional scaffold promoting cell proliferation and differentiation is critical in periodontal tissue engineering. The objective of this study was to evaluate the biocompatibility of a novel porcine acellular dermal matrix as periodontal tissue scaffolds both in vitro and in vivo. The scaffolds in this study were purified porcine acellular dermal matrix (PADM) and hydroxyapatite-treated PADM (HA-PADM). The biodegradation patterns of the scaffolds were evaluated in vitro. The biocompatibility of the scaffolds in vivo was assessed by implanting them into the sacrospinal muscle of 20 New Zealand white rabbits. The hPDL cells were cultured with PADM or HA-PADM scaffolds for 3, 7, 14, 21 and 28 days. Cell viability assay, scanning electron microscopy (SEM), hematoxylin and eosin (H&E) staining, immunohistochemistry and confocal microscopy were used to evaluate the biocompatibility of the scaffolds. In vitro, both PADM and HA-PADM scaffolds displayed appropriate biodegradation pattern, and also, demonstrated favorable tissue compatibility without tissue necrosis, fibrosis and other abnormal response. The absorbance readings of the WST-1 assay were increased with the time course, suggesting the cell proliferation in the scaffolds. The hPDL cells attaching, spreading and morphology on the surface of the scaffold were visualized by SEM, H&E staining, immnuohistochemistry and confocal microscopy, demonstrated that hPDL cells were able to grow into the HA-PADM scaffolds and the amount of cells were growing up in the course of time. This study proved that HA-PADM scaffold had good biocompatibility in animals in vivo and appropriate biodegrading characteristics in vitro. The hPDL cells were able to proliferate and migrate into the scaffold. These observations may suggest that HA-PADM scaffold is a potential cell carrier for periodontal tissue regeneration. Grafting a new biologically derived matrix onto damaged dental tissue may help cell regeneration, research from China and the USA shows. Guo-qiang Guan at the State University of New York, USA, and co-workers at that institute and Shandong University, China, have successfully designed and trialed a matrix scaffold for use in the repair of periodontal tissues, which surround and support the teeth. The team removed cells from sections of pig tissue, while leaving the extracellular framework intact to create so-called 'porcine acellular dermal matrix' (PADM) grafts. They then treated the PADMs with hydroxyapatite (HA) — a mineral form of calcium apatite similar to that found in dental enamel and dentin. The HA-PADM provided an excellent, biodegradable scaffold for the regeneration of periodontal tissue cells both in laboratory cultures and in rabbits.
The Hot Bath Test and Multiple Sclerosis
Authors: Joseph R. Berger
Journal: JAMA (1982)

To the Editor.—  In the article  Hot Bath Test in the Diagnosis of Multiple Sclerosis by Hershel Goren, MD, and Amir S. Malhotra, MD (1981; 246:1113), the neurological changes that occurred in 17 of their 20 patients with multiple sclerosis (MS) resolved when body temperature returned to normal. While the worsening that accompanies hyperthermia in MS is generally transient,1,2we have observed three persons who experienced debilitating, long-lasting neurological complications after hot bath testing.  The patients ranged in age from 19 to 53 years, and all had  MS. Visual impairment appeared with elevation of body temperature in two patients and papillitis was noted within 24 hours. Hot bath testing in the third patient resulted in a moderate, left hemiparesis. This deficit was resolving at 48 hours when she became hemiplegic during a hot shower.  The hot bath test is not without risk. Because of its possible serious
Firearm Legislation and Gun-Related Fatalities—Reply
Authors: Eric W. Fleegler, Michael Monuteaux, Rebekah Mannix
Journal: JAMA Internal Medicine (2013)

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For Some, Candidate Positions on Health Care Remain Short on Specifics, Leave Many Questions
Authors: Paul Cotton
Journal: JAMA (1992)

PROMISES on health care reform litter the 1992 Presidential campaign trail, yet many voters say they feel they must scrounge around for details. "I hope this hasn't been too long and too specific," said incumbent Republican George Bush in concluding a 20-minute speech dedicated to health care at a site not far from Cleveland, Ohio. It was not, according to even ardent supporters. "Where's the money coming from, is what I want to know," was Bush fan Bob Bolzer's question after the Oktoberfest pancake breakfast address in Painesville, Ohio, suburban Rust Belt turf considered crucial to winning this election. Cutting waste is fine, says Bolzer, but "there's going to be a tax uprising if they raise taxes anymore." Carl Bencic, whose family puts on the annual event where Bush has campaigned since 1980, liked what he heard about cutting waste, eliminating preexisting conditions exclusions, and providing voucher and tax credits
Preliminary experience of endoscopic submucosal tunnel dissection for upper gastrointestinal submucosal tumors
Authors: W. Gong, Y. Xiong, F. Zhi, S. Liu, A. Wang, B. Jiang
Journal: Endoscopy (2012)

<b>Background and study aim:</b> Although the majority of submucosal tumors (SMTs) are benign, some do have a malignant potential. Resection of SMTs would aid in establishing the diagnosis and may be curative. Our aim was to examine the feasibility and safety of a novel method for endoscopic resection of upper gastrointestinal SMTs. <b>Patients and methods:</b> In 12 patients who presented with an upper gastrointestinal SMT of ≤ 40 mm located in the esophagus or cardia, a submucosal tunnel was endoscopically created starting approximately 5 cm proximal to the lesion. After careful submucosal dissection with carbon dioxide or air insufflation, the SMTs were completely removed, and the entrance of the tunnel closed using endoclips. <b>Results:</b> SMTs had a mean size of 19.5 mm (range 10 – 40 mm); eight were located in the esophagus and four in the cardia. SMT resection was successful in all patients with en bloc resection in 10 patients (83.3 %) and resection in two pieces in the remaining two patients. The mean time required for the procedure was 48.3 minutes (range 30 – 60 minutes). Two patients had both pneumothorax and subcutaneous emphysema. All the complications resolved with conservative management. <b>Conclusions:</b> In this pilot study, endoscopic submucosal tunnel dissection (ESTD) of esophageal and cardia SMTs was effective and appeared to be safe. Larger studies that also examine its application for gastric SMTs are warranted.
Power to the people: what will bring about the patient centred revolution?
Authors: P. Hodgkin, J. Taylor
Journal: BMJ (2013)

<h3>BACKGROUND:</h3> Protective lung ventilation requires calculating predicted body weight (BW) from height. Thus, inaccuracy of height data in the electronic health record (EHR) is a risk factor for ventilator-induced lung injury. Charted height data often have uncertain accuracy. Study purposes were (1) to evaluate the difference between patient height charted in the EHR and predicted height (PH) from ulnar length and (2) to determine how the height data source affects predicted BW and the resulting values for protective tidal volume (V<sub>T</sub>). <h3>METHODS:</h3> Subject height data from the EHR were collected from several ICUs. Simultaneous ulnar data were collected by measuring ulnar length (cm): <i>male</i> PH (cm) = 79.2 ± 3.60 × ulnar length; <i>female</i> PH = 95.6 ± 2.77 × ulnar length. For each subject, BW (kg) was calculated from height <i>charted</i> in EHR and from <i>predicted</i> height: <i>male</i> BW = 50 ± 0.91 × (height − 152.4); <i>female</i> BW = 45.5 ± 0.91 × (height − 152.4). Then V<sub>T</sub> was calculated as 8 mL/kg BW. Bland-Altman analysis of height and V<sub>T</sub> differences (charted − predicted) determined the limits of agreement. <h3>RESULTS:</h3> For white males (<i>n</i> = 27) the mean (SD) height from EHR was 177 (7.5); predicted height was 178 (6.9). The limits of agreement for height in males were −18.5 and 17.8 cm. The limits of agreement for females were −23.1 and 21.3 cm. The limits of agreement for V<sub>T</sub> in males were −1.8 and 1.8 mL/kg. The limits of agreement for V<sub>T</sub> in females were −3.0 and 2.9 mL/kg. <h3>CONCLUSIONS:</h3> For overall populations, mean height calculated from values charted in the EHR is similar to that estimated from ulnar length. However, for individuals, differences in height between the 2 sources can be large, leading to large differences in predicted BW and resultant V<sub>T</sub> set in terms of mL/kg.