tbuckley/cabot-search huggingface dataset:
BMA consults GMC about cash incentives to GPs to cut patient care
Authors: C. White
Journal: BMJ (2012)

Doctors’ leaders have approached the General Medical Council to see whether it would be prepared to bring pressure to bear on GPs who continue to pare back elements of patient care in return for financial reward.

Some of the outgoing primary care trusts had set targets for GPs to cut back on expensive items, such as some referrals or prescribing, and had rewarded doctors who reached them, in a bid to reduce spending.

The tactic, which included the quality premium—a cash bonus for commissioning performance—attracted widespread condemnation from …
Anterograde Axonal Transport of AAV2-GDNF in Rat Basal Ganglia
Authors: Agnieszka Ciesielska, Gabriele Mittermeyer, Piotr Hadaczek, Adrian P Kells, John Forsayeth, Krystof S Bankiewicz
Journal: Molecular Therapy (2010)

We elucidated the effects of parkinsonian degeneration on trafficking of AAV2-GDNF in the nigro-striatum (nigro-ST) of unilaterally 6-hydroxydopamine (6-OHDA)-lesioned rats. Vector infused into striatum (ST) was transported to substantia nigra (SN), both pars compacta (SNc), and pars reticulata (SNr). In the lesioned hemisphere, glial cell line–derived neurotrophic factor (GDNF) immunoreactivity was only found in SNr consistent with elimination of SNc dopaminergic (DA) neurons by 6-OHDA. Further analysis showed that striatal delivery of AAV2-GDNF resulted in GDNF expression in globus pallidus (GP), entopeduncular nucleus (EPN), and subthalamic nucleus (STN) in both lesioned and unlesioned hemispheres. Injection of vector into SN, covering both SNc and SNr, resulted in striatal expression of GDNF in the unlesioned hemisphere but not in the lesioned hemisphere. No expression was seen in GP or EPN. We conclude that adeno-associated virus serotype 2 (AAV2) is transported throughout the nigro-ST exclusively by anterograde transport. This transport phenomenon directs GDNF expression throughout the basal ganglia in regions that are adversely affected in Parkinson's disease (PD) in addition to SNc. Delivery of vector to SN, however, does not direct expression of GDNF in ST, EPN, or GP. On this basis, we believe that striatal delivery of AAV2-GDNF is the preferred course of action for trophic rescue of DA function. We elucidated the effects of parkinsonian degeneration on trafficking of AAV2-GDNF in the nigro-striatum (nigro-ST) of unilaterally 6-hydroxydopamine (6-OHDA)-lesioned rats. Vector infused into striatum (ST) was transported to substantia nigra (SN), both pars compacta (SNc), and pars reticulata (SNr). In the lesioned hemisphere, glial cell line–derived neurotrophic factor (GDNF) immunoreactivity was only found in SNr consistent with elimination of SNc dopaminergic (DA) neurons by 6-OHDA. Further analysis showed that striatal delivery of AAV2-GDNF resulted in GDNF expression in globus pallidus (GP), entopeduncular nucleus (EPN), and subthalamic nucleus (STN) in both lesioned and unlesioned hemispheres. Injection of vector into SN, covering both SNc and SNr, resulted in striatal expression of GDNF in the unlesioned hemisphere but not in the lesioned hemisphere. No expression was seen in GP or EPN. We conclude that adeno-associated virus serotype 2 (AAV2) is transported throughout the nigro-ST exclusively by anterograde transport. This transport phenomenon directs GDNF expression throughout the basal ganglia in regions that are adversely affected in Parkinson's disease (PD) in addition to SNc. Delivery of vector to SN, however, does not direct expression of GDNF in ST, EPN, or GP. On this basis, we believe that striatal delivery of AAV2-GDNF is the preferred course of action for trophic rescue of DA function.
Fighting the War on Breast Cancer
Authors: Maryann Napoli
Journal: Annals of Internal Medicine (1999)

Letters2 February 1999Fighting the War on Breast CancerMaryann NapoliMaryann NapoliCenter for Medical Consumers; New York, NY 10012Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-3-199902020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Lerner provided an instructive historical context for the recent mammography debate (1). I disagree with his contention that the “often vitriolic and accusatory” language in this debate is due to the language of advocacy, specifically the use of war metaphors. As an advocate, I have another view. The mammography screening advice to the public was premature, one-sided, and outright harmful because it led to overtreatment of noninvasive lesions that have an unknown natural history (2).In the early 1970s, the American Cancer Society and the National Cancer Institute began promoting mammography screening on the basis of ...References1. Lerner BH. Fighting the war on breast cancer: debates over early detection, 1945 to the present. Ann Intern Med. 1998;129:74-8. LinkGoogle Scholar2. Ketcham AS, Moffat FL. Vexed surgeons, perplexed patients, and breast cancers which may not be cancer. Cancer. 1990;65:387-93. CrossrefMedlineGoogle Scholar3. Carbone PP. A lesson from the mammography issue. Ann Intern Med. 1978;88:703-4. LinkGoogle Scholar4. Screening for breast cancer. In: U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. Bethesda, MD: Department of Health and Human Services, Public Health Service, DPHP; 1996:80-1. Google Scholar Author, Article, and Disclosure InformationAuthors: Maryann NapoliAffiliations: Center for Medical Consumers; New York, NY 10012 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFighting the War on Breast Cancer: Debates over Early Detection, 1945 to the Present Barron H. Lerner Fighting the War on Breast Cancer Barron H. Lerner Metrics 2 February 1999Volume 130, Issue 3Page: 243KeywordsArmed forcesBreast cancerCancer geneticsCancer screeningGenetic testingLesionsMammographyRadiologists ePublished: 15 August 2000 Issue Published: 2 February 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Effects of diltiazem and noradrenaline on extracellular potassium changes in the globally ischaemic rat heart
Authors: A. Mitani, K. Kinoshita, K. Fukamachi, M. Sakamoto, K. Kurisu, F. Fukumura, Y. Tsuruhara, A. Nakashima, K. Tokunaga
Journal: Cardiovascular Research (1992)

The aim was to investigate the effects of a calcium antagonist (diltiazem) and a catecholamine (noradrenaline) on extracellular potassium accumulation during global ischaemia.Extracellular potassium concentration ([K+]e) was measured during 30 min global ischaemia in the isolated rat heart using a valinomycin potassium sensitive electrode. Contracture development during ischaemia was measured throughout with an intraventricular balloon inserted into the left ventricle and myocardial adenine nucleotides were measured in separate series of hearts.In control hearts, [K+]e showed a characteristic triphasic change during 30 min global ischaemia. This consisted of an early rising phase followed by a transient falling phase after the initial peak of [K+]e, and then a late rising phase. Diltiazem suppressed the rate of rise of [K+]e during early ischaemia, but extended the time course of the early [K+]e rise with the higher dose, abolishing the transient falling phase of [K+]e. During late ischaemia, the rise in [K+]e was attenuated by diltiazem. Noradrenaline also suppressed the early extracellular potassium accumulation, but in contrast to diltiazem, hastened the time course of the late [K+]e rise.Although diltiazem suppresses the early potassium loss during ischaemia as previously described, the drug also decreases the [K+]e fall by some as yet unknown mechanism, so that the [K+]e level becomes higher than control during the falling phase.
Court Involvement in Right-to-Die Cases: Judicial Inquiry in New York
Authors: William J. Curran
Journal: New England Journal of Medicine (1981)

Jarndyce and Jarndyce drones on. This scarecrow of a suit has, in course of time, become so complicated that no man alive knows what it means.—Charles DickensTHE American courts continue to involve themselves — perhaps to become irrevocably entangled — in issues of clinical decision making for certain incompetent patients who might die without vigorous treatment. In the popular press, these complex legal cases are all grouped under the colorful and emotional description of the "right to die."One of the most publicized of the cases has been that of Brother Joseph Fox, an 83-year-old member of a . . .
Domestic Violence Against Women
Authors: Bruce Schlafly
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Throughout their report, the authors discuss domestic violence to women caused by a "boyfriend or husband." Although the women who were the subjects of this investigation were given a questionnaire that inquired about marital status, the authors do not reveal the marital status of the women subjected to domestic violence. Although it may be a politically incorrect question to ask, I wonder if the authors could tell us what percentage of women reporting domestic violence were legally married at the time that the domestic violence was inflicted on them?
High interleukin 12 and low interleukin 10 production after in vitro stimulation detected in sepsis survivors
Authors: Spaska A. Stanilova, Zhivko T. Karakolev, Gospodin S. Dimov, Zlatka G. Dobreva, Lyuba D. Miteva, Emil S. Slavov, Chavdar S. Stefanov, Noyko S. Stanilov
Journal: Intensive Care Medicine (2005)
Investigations in Paediatrics
Authors: L. Hutchinson
Journal: BMJ (1995)

Ed Douglas P Addy Saunders, £27, pp 314 ISBN 0 7020 1737 X

I have always envied those doctors who sum up their entries in patients' notes with a clear, precise “impression” and “plan.” The more complicated and diverse the case the more humbling it is to read their logical, well thought out suggestions for investigations and treatment. In paediatrics it is important to have a sensible approach as children can be technically difficult to investigate and most tests can be physically and emotionally difficult for the child and family. An unwell child needs appropriate care, and although there is …
CT densitometry as a predictor of pulmonary function in lung cancer patients
Authors: Fiachra Moloney, Sebastian McWilliams, Marcus Kennedy, Michael Maher, Mike Henry
Journal: European Respiratory Journal (2011)

Purpose: Preoperative pulmonary assessment is undertaken in patients with resectable lung cancer to identify those at increased risk of perioperative complications. Guidelines from the American College of Chest Physicians indicate that if the FEV1 and DLCO are ≥60% of predicted, patients can undergo resection without further evaluation. 1

The aim of our study is to determine if CT can predict pulmonary function in lung cancer patients and identify patients who would tolerate surgical resection.

Materials and methods: Patients were identified retrospectively from the Cork University Hospital lung cancer database. The total lung volume, the volume of normal lung parenchyma (values -500 HU to -900 HU), the emphysematous volume (values less than -900 HU), and the mean lung density were determined for each patient using the OsiriX digital analysis programme.

Results: A total of 77 patients were enrolled. FEV1 was found to correlate significantly with the mean lung density (r=.762, p<.001) and the emphysematous volume (values less than -900 HU) (r= -.678, p<.001). DLCO correlated significantly with the mean lung density (r =.648, p<.001).

Through multivariate regression analysis, a cumulative prediction tool to predict pulmonary function was designed. The prediction tool was internally valid as there was no significant difference observed between the pulmonary function measures acquired by spirometry and the measures obtained using our prediction tool.

CT had a sensitivity of 84% and a specificity of 81% at detecting patients that require further assessment beyond pulmonary function testing.

Conclusion: Use of our prediction tool can predict pulmonary function in lung cancer patients.
TRENDS IN LOWER EXTREMITY AMPUTATIONS IN PERIPHERAL ARTERY DISEASE PATIENTS: RESULTS FROM U.S. MEDICARE 2000-2008
Authors: William Schuyler Jones, Manesh Patel, Dadi (David) Dai, Sumeet Subherwal, Judith Stafford, Sarah Calhoun, Eric Peterson
Journal: Journal of the American College of Cardiology (2012)
THE APPLICATION OF FUNGI AS STYPTICS
Authors: E. Knight
Journal: BMJ (1913)

GIiAVESEND."'vesse-de-lo best, which SEVERAL species of fungus were largely used in formner causing eithu times as applications for arresting lhaeinorrhage, both by most powder peole slices and al surgeons and the common people.se they ar Dioscorides ' mentions agaric (dyaptKov) as a fungus kind of glue springing from the trunks of rotting trees, and states that tlhree obols of it taken with water stays spitting of blood.This wasThe fungus was so-called because it wais found at Agaria, during whi in Sarmatia.Linnaeus in hlis classification of plants Adrien Hel adopted the Latin term Agaricus for a large genuls of being plhys funai.But in pharmacv now the name " agaric " is usually Paris to ve given to various corky species of Polyporus growing on treatina miia trees-as the P. officinalis, chiefly found on the larelh, the a drug almn P. fomnentarius on the oak and birch, and the P. ignariuis sum by the on the willow, plum, and cherry.During tlle eighteenth of his CUrF century the agaric of Gak was often laid on bleeding Chlaulnes, a wounds by French surgeons.Audouillet applied pieces to Colbert to I the mouths of bleeding vessels after several capital as a physici amnputations with good resuIlts, It was also used success-
GMC reviews assessor's appointment
Authors: C. Grant
Journal: BMJ (1998)

The General Medical Council is reviewing its provisional appointment of a gynaecologist to oversee the retraining of doctors after a television programme revealed that he had been forced out of three hospitals and had his licence to practise revoked in Ontario.

Mr Richard Neale had applied to be one of about 400 assessors who would oversee the retraining and rehabilitation of doctors whose performance was found to be seriously deficient. …
Hospital Governing Boards-Reply
Authors: Albert J. Miller
Journal: JAMA (1982)

<h3>In Reply.—</h3> I appreciate Dr Tulsky's comments supporting the position presented in my COMMENTARY and agree with him that physicians serving on hospital boards must be qualified in the way he describes. His letter particularly interests me because it so effectively reflects the many comments I have had from physicians who have written and spoken to me. The level of interest appears to be substantial. Indeed, I have been informed that copies of the "open letter" have been distributed to all the board members of a considerable number of medical institutions.
Aldosterone and parathyroid hormone: a precarious couple for cardiovascular disease
Authors: A. Tomaschitz, E. Ritz, B. Pieske, A. Fahrleitner-Pammer, K. Kienreich, J. H. Horina, C. Drechsler, W. Marz, M. Ofner, T. R. Pieber, S. Pilz
Journal: Cardiovascular Research (2012)

Animal and human studies support a clinically relevant interaction between aldosterone and parathyroid hormone (PTH) levels and suggest an impact of the interaction on cardiovascular (CV) health. This review focuses on mechanisms behind the bidirectional interactions between aldosterone and PTH and their potential impact on the CV system. There is evidence that PTH increases the secretion of aldosterone from the adrenals directly as well as indirectly by activating the renin-angiotensin system. Upregulation of aldosterone synthesis might contribute to the higher risk of arterial hypertension and of CV damage in patients with primary hyperparathyroidism. Furthermore, parathyroidectomy is followed by decreased blood pressure levels and reduced CV morbidity as well as lower renin and aldosterone levels. In chronic heart failure, the aldosterone activity is inappropriately elevated, causing salt retention; it has been argued that the resulting calcium wasting causes secondary hyperparathyroidism. The ensuing intracellular calcium overload and oxidative stress, caused by PTH and amplified by the relative aldosterone excess, may increase the risk of CV events. In the setting of primary aldosteronism, renal and faecal calcium loss triggers increased PTH secretion which in turn aggravates aldosterone secretion and CV damage. This sequence explains why adrenalectomy and blockade of the mineralocorticoid receptor tend to decrease PTH levels in patients with primary aldosteronism. In view of the reciprocal interaction between aldosterone and PTH and the potentially ensuing CV damage, studies are urgently needed to evaluate diagnostic and therapeutic strategies addressing the interaction between the two hormones.
False Positive Uptake of Cavernous Hemangioma With Tc-99m HMPAO-Labeled Leukocytes
Authors: Seher Nilgün Ünal, Cüneyt Türkmen, Şeyma Ekmekçi, Sema Cantez
Journal: Clinical Nuclear Medicine (2009)

Infection remains a major cause of patient morbidity and mortality. The role of Tc-99m HMPO leukocyte imaging plays an important role in the diagnostic evaluation of the patient suspected of harboring infection. There are some limitations to the use of leukocytes. False positive results have been described with Tc-99m HMPAO-labeled leukocytes in sterile hematomas, bleeding wounds, and wounds healing by secondary infection, tumors, cerebral infarction, tracheotomy and colostomy sites, vascular access lines, and dialysis catheters. We present a case of false positive uptake of Tc-99m HMPAO-labeled leukocytes in a 7 year old child with a cavernous hemangioma.
Cobalt 60 Irradiation for Advanced Carcinoma of the Palatine Tonsil
Authors: Herbert E. Brizel
Journal: JAMA (1965)

CARCINOMA of the palatine tonsil is the second most common malignancy of the oropharynx. Early lesions have an excellent chance for cure but offer difficulty in diagnosis. The majority develop insidiously and present as advanced disease, both locally and by cervical adenopathy. Carcinoma originating in the tonsillar fossa can easily spread to the anterior and posterior pillars, pharyngeal wall, soft palate, tongue, gingiva, and mandible. Because of the rich lymphatic supply of the region, lymph node metastases are a common presenting sign.<sup>1</sup> Until recently, irradiation and surgery have had little to offer in the advanced cases. A high percentage of postoperative complications followed the required ultraradical resection. Radiotherapy, without the general availability of supervoltage or telecobalt, encountered difficulties in delivering a tumorcidal dose to the required large volume without damage to the normal surrounding bone and soft tissue. In recent years there has been a renaissance of the surgical
Endoscopic Retrograde Cholangiopancreatography
Authors: John B. Marshall
Journal: JAMA (1983)

<h3>To the Editor.—</h3> In their recent editorial (1983;249:783), Craig and Clayman state that percutaneous transhepatic cholangiography (PTC) is preferable to endoscopic retrograde cholangiopancreatography (ERCP) in the examination of patients with obstructive jaundice shown to have dilated ducts on ultrasound. At a center like ours with a high success rate of cannulating the common bile duct, we believe that ERCP may offer advantages over PTC in some cases and be the procedure of choice in the evaluation of obstructive jaundice regardless of whether there are dilated bile ducts on ultrasound. First, ERCP allows inspection of the papilla of Vater and duodenum, which may be abnormal with ampullary or duodenal cancer. Endoscopic biopsy can be performed in these instances to give a definitive diagnosis. Second, ERCP allows visualization of the pancreatic duct, which may be advantageous in diagnosing pancreatic cancer and obstructive jaundice caused by chronic pancreatitis. In the occasional case of
Delayed detection of congenital hearing loss.
Authors: R T Shortridge, N Bulmer
Journal: BMJ (1990)

Clinically pseudo-seizures may be mistaken for genuine fits as they are usually tonic-clonic in appearance, although occasionally manifesting as complex partial seizures.Certain features are helpful in differentiation, including gaze aversion, resistance to passive limb movement or eye opening, prevention of the hand falling on to the face, and induction by suggestion.3Previously normal electroencephalograms, particularly during an attack, or normal serum prolactin concentrations during a pseudo-seizure can be useful in supporting the diagnosis.4Status epilepticus is a medical emergency that requires prompt treatment with anticonvulsants.Patients with pseudo-status epilepticus, however, are more at risk from medical treatment than from their condition, and early recognition of pseudo- seizures would avoid iatrogenic complications.This might be facilitated by rapid access to a register of patients with pseudo-seizures.The register should be held in local accident and emergency departments in the region as these patients may attend many hospitals.
Biodegradable polymeric vesicles containing magnetic nanoparticles, quantum dots and anticancer drugs for drug delivery and imaging
Authors: Fei Ye, Åsa Barrefelt, Heba Asem, Manuchehr Abedi-Valugerdi, Ibrahim El-Serafi, Maryam Saghafian, Khalid Abu-Salah, Salman Alrokayan, Mamoun Muhammed, Moustapha Hassan
Journal: Biomaterials (2014)
Management of acute bacterial meningitis
Authors: A.F Maggs, Keith Williams, Roélien Enting, Jan de Gans, Ian Eltringham, Michael Martin, Karl Birthistle, Paul Lee, Giorgio Tamburlini, Adriano Cattaneo, Rubén Schindler Maggi, Anna Macaluso, Silvia Pivetta, StevenK Obaro, AllanR Tunkel, W Michael Scheld, Brian Watt
Journal: The Lancet (1996)
Some HIV patients can stop taking prophylaxis against infections
Authors: S. Gottlieb
Journal: BMJ (1999)

Patients infected with HIV whose immune systems have responded well to combination antiretro-viral treatment can stop taking prophylaxis for Pneumocystis carinii pneumonia, a study in the New England Journal of Medicine has found (1999;340:1301-6).

The study, conducted by Dr Hansjakob Furrer and colleagues from the Bern Hospital in Switzerland, followed 262 patients who had stopped taking the prophylaxis. While the patients were on …
The Ultrasonic Tactile Sensor: In Vivo Clinical Application for Evaluation of Depth of Invasion in Esophageal Squamous Cell Carcinomas
Authors: T. Yoshida, H. Inoue, T. Kawano, K. Takeshita, T. Iwai
Journal: Endoscopy (1999)

The depth of invasion of esophageal cancer is usually evaluated using radiographic examination (barium study), normal endoscopy, chromoendoscopy, endoscopic ultrasonography (EUS) [1] [2], computed tomography (CT), or magnetic resonance imaging (MRI). These examinations are based on the morphology of the tumors. Evaluations of this type, while useful, can be prone to errors because of their subjective nature. An accurate evaluation of invasion is needed to distinguish between mucosal and submucosal cancer. This differentiation is critically important as the surgical treatments for the different stages, namely, endoscopic mucosal resection (EMR) [3] or conventional open esophagectomy with regional lymph node dissections, involve very different degrees of operative stress for the patient.