tbuckley/cabot-search huggingface dataset:
PTH-133 Patient Satisfaction with a Nurse-Delivered Alcohol Liaison Service in a General Hospital Setting
Authors: C Oza, R Price, S Morris, W Lambert, M Al-Mahbub, P Southern
Journal: Gut (2013)

<h3>Introduction</h3> NICE Guidance has mandated the need to provide an Alcohol Liaison Service (ALS) within all Acute Trusts (1). Within our organisation, we have a mature ALS which provides advice and support to prospectively identified patients admitted to the Acute Medical Service. This audit was undertaken to seek the views of service users, and to ensure that we were fulfilling their needs and expectations, thus allowing feedback on future service development. <h3>Aim</h3> To assess the patient acceptance of a Nurse-Led Alcohol Liaison Service <h3>Methods</h3> All patients admitted to Medical Admissions Unit (MAU), had an alcohol assessment using the validated AUDIT (2) nursing questionnaire. Those scoring ≥ 5 were flagged to the Alcohol Liaison Service. Similarly, a high percentage of patients seen in A&amp;E were screened by the nurses, given extended brief advice, then offered referral to Specialist Alcohol Worker (SAW) All patients seen by SAW, and by Alcohol Clinical Nurse Specialist (ACNS) over a 6 week period were given a questionnaire and sealed envelopes, to be returned anonymously. <h3>Results</h3> 95 questionnaires were distributed by the ACNS, and 79 were returned (return rate 83%). 10 questionnaires had technical printing errors, so were excluded from final analysis, so the ITT return rate was 73%. 32 questionnaires were distributed by the SAW, with a 100% return rate. The first 3 questions dealt with quality of the service, and were numerically scored from 1–4, with 1 being poor, and 4 being excellent. When asked <i>‘How would you rate the quality of the service you have received</i>?<i>’</i> 97% answered 3 or 4 (good or excellent). When asked if the service had met their needs, 88% of clients stated that it had. The remainder of the questionnaire dealt with acceptance of the service, and whether the service would be recommended to peers. When asked whether clients would recommend a friend to the service, 90% responded positively. The scores for the SAW were even better, with positive responses (outcome 3 or 4 on questionnaire) 100% of the time. <h3>Conclusion</h3> This work illustrated the acceptance and value of the ALS to service users admitted acutely. Furthermore, free text responses received were overwhelmingly supportive and positive towards the service. <h3>Disclosure of Interest</h3> None Declared. <h3>References</h3> Alcohol-use disorders: preventing the development of hazardous and harmful drinking, NICE Public Health Guidance 24, June 2010 The AUDIT (Alcohol Use Disorders Identification Test), World Health Organisation, Saunders JB, Aasland OG, Babor TF, <i>et al.</i> Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993 Jun; 88(6):791–804
Tissue typing for HFE mutations
Authors: Stuart Raaka, Kier V. Huehnergarth, Kris V. Kowdley, Mary P. Bronner
Journal: Hepatology (2002)

Many reports, mostly from Italy, have shown the association of hepatitis C virus (HCV) infection with the development of B-cell non-Hodgkin's lymphoma (NHL), although this is still controversial probably because of endemic or ethnic differences in HCV infection. [1]2][3][4][5][6][7][8] Prevalence of HCV infection has also been reported to be age and sex specific. 9,10 Osaka is an HCV-endemic area. 9 To investigate a possible link between HCV infection and B-cell NHL, we compared the prevalence of HCV infection in Japanese patients having B-cell NHL with that in first-time voluntary birth cohort-and sex-matched controls in Osaka, Japan.We studied 187 consecutive Japanese patients with NHL, consisting of 156 B-cell NHL and 31 T-cell NHL patients who resided in Osaka and were admitted to our hospitals in Osaka for the initial treatment of NHL between 1994 and 2000.Anti-HCV antibody was measured on admission before beginning initial treatment.Therefore, the patients had never received any blood transfusion for the treatment of NHL before the measurement of anti-HCV antibody.For birth cohort-and sex-matched controls, we used the screening data of 197,600 first-time voluntary blood donors to the Osaka Red Cross Blood Center from February 1992 to July 1992 who resided in Osaka. 9 We calculated the expected number of anti-HCV-positive individuals by multiplying the 5-year birth cohort-and sex-specific prevalence rate of anti-HCV antibodies among blood donors by the corresponding number of patients with NHL.In 21 of 156 (13.5%) patients with B-cell NHL, anti-HCV antibody was positive.Only 2 among 31 (6.5%) pa-
The Right to Health and the Nevirapine Case in South Africa
Authors: George J. Annas
Journal: New England Journal of Medicine (2003)

This article describes the successful legal challenge of the South African government's controversial decision to restrict the availability of nevirapine for use in preventing the transmission of the human immunodeficiency virus (HIV) from mother to infant. With its order requiring the government to provide comprehensive health services to prevent mother-to-child transmission of HIV, the Constitutional Court of South Africa upheld the public's right to health care, as guaranteed in the South African constitution.
No time to train the surgeons:Only repeal of European Working Time Directive will help
Authors: Neville W Goodman
Journal: BMJ (2004)

Editor—The really depressing aspect of the pithy and well argued editorial by Chikwe et al is that the outcome has been obvious for years.1 The European Working Time Directive is a disaster for medicine.

No amount of teaching in classrooms can compensate for practical experience. No reorganisation of hospital medicine, grades, or subdoctor “assistants” will help. Only a repeal of the directive will do that.
In situ hybridization studies in hepatitis A infection
Authors: Michael G. Taylor, Robert D. Goldin, Peter Karayiannis, Howard C. Thomas
Journal: Hepatology (1992)

An in situ hybridization method using radiolabeled oligonucleotide probes was developed to study primary sites of hepatitis A virus replication in an experimental animal model of infection. Hepatitis A genomic sequences were demonstrated in hepatocytes of four marmosets with acute hepatitis A by use of antisense probes. In two of these animals, staining was also found when a sense probe was used, which is consistent with active replication in the hepatocytes. The specificity of the hybridization signal was confirmed by neutralization with "cold" (i.e., unlabeled) probes and by absence of hybridization with non-A hepatitis and reverse antisense probes. The hepatocyte appeared to be the only cell type showing staining. No hybridization was found in other organs, including the intestine (n = 4) and, in one animal, the kidney and spleen.
Who Is Still Uninsured in Minnesota?
Authors: Kathleen Thiede Call
Journal: JAMA (1997)

<h3>Objective.</h3> —To describe Minnesota's health care system reform efforts and their implications for other state and national reform initiatives, document the rate of uninsurance in 1990 and 1995 with special attention to childrens' access to health insurance, and examine the effectiveness of Minnesota Care, a voluntary statesubsidized health care plan, in serving its target population. <h3>Design.</h3> —Three cross-sectional telephone surveys: 2-stage random samples of Minnesotans of all ages in 1990 and 1995 and a stratified random sample of Minnesota Care enrollees in 1994. <h3>Participants.</h3> —For the 2 statewide surveys, 10310 respondents participated in 1990 and 11 519 in 1995; more detailed information was collected on approximately 1600 respondents in each survey. Eight hundred Minnesota Care enrollees participated in the third survey conducted in 1994. <h3>Main Outcome Measure.</h3> —Changes in rates of uninsurance. <h3>Results.</h3> —While the rate of uninsurance increased at the national level, the point-in-time Minnesota rate remained stable and low at 6% between 1990 and 1995. The proportion of children uninsured for 12 months or more decreased from 5.2% in 1990 to 3.1% in 1995, while the proportion of uninsured single adults remained stable at approximately 11%. There was no evidence that Minnesota Care enrollees are gaming the program, or that the program has resulted in significant erosion from the private market. <h3>Conclusions.</h3> —Minnesota Care has enabled the state to maintain a low rate of uninsurance and has reduced this rate among its primary target: children. The program has been less effective in enrolling single adults, although it may be too early to witness the effects of recent expansions targeting this group. Minnesota's experience suggests that other state and national reform efforts aimed at reducing uninsurance, particularly among children, are likely to be successful.
DOCK8 Deletions and Mutations Are Associated With The Autosomal Recessive Hyper-IgE Phenotype
Authors: S.A. McGhee, K. Engelhardt, S. Winkler, A. Sassi, C. Woellner, G. Lopez-Herrera, A. Chen, H. Kim, M. Garcia Lloret, I. Schulze, S. Ehl, J. Thiel, D. Pfeifer, H. Veelken, T. Niehues, K. Siepermann, S. Weinspach, I. Reisli, S. Keles, F. Genel, N. Kütükçüler, Y. Camcioglu, A. Somer, E. Karakoc-Aydiner, I. Barlan
Journal: Journal of Allergy and Clinical Immunology (2010)
Primary Vesicoureteral Reflux and End-Stage Renal Disease
Authors: Oscar Salvatierra
Journal: JAMA (1973)

Eighteen patients with end-stage renal failure secondary to primary bilateral vesicoureteral reflux are presented. These cases document a potential terminal phase in the natural history of vesicoureteral reflux. Five patients had sterile reflux alone, and four patients probably had sterile reflux until urinary tract infection occurred at our near endstage renal failure. The remaining patients had reflux associated with recurring urinary tract infection. Early diagnosis and proper management are important in vesicoureteral reflux.
Ultraviolet Light Hazards From Phototherapy
Authors: Robert L. Elder
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The appearance of erythema on the skin of two infants exposed to fluorescent lights as treatment for hyperbilirubinemia has come to the attention of the Food and Drug Administration. On-site investigation of the incident by personnel of the FDA Bureau of Radiological Health indicated that the clinical determination of erythema was consistent with the measured ultraviolet exposure levels. The occurrence indicates an urgent need to alert physicians and hospitals to the possibility of injury to the exposed infant from certain exposure conditions that may be used in phototherapy. Hazardous levels of ultraviolet radiation (which are not effective in phototherapy) and extremely intense visible radiations can be present in the output of fluorescent lamps. The agency strongly recommends that any institution, or physician, using phototherapy in the treatment of hyperbilirubinemia immediately take the following precautions: Shield fluorescent lamps with ultraviolet-absorbing filter materials made from selected plastics or
STUDIES ON ENDOTHELIAL REACTIONS
Authors: Nathan Chandler Foot
Journal: The Journal of Experimental Medicine (1921)

1. Lymphocytes were usually the first cells to migrate out into the plasmic clot from explanted pieces of lymph nodes. 2. Their paths of migration were irregular but in general they proceeded away from the explant. 3. The lymphocytes migrated at rates varying from 0.03 to 0.0013 mm. per minute. The rate of any one varied from minute to minute, and they often came to rest for varying lengths of time. 4. The migrating lymphocytes were very much elongated, with the nucleus always near the anterior end. The elongated tail contained the endoplasm with a few granular mitochondria and usually a few granules which took up neutral red. 5. The lymphocytes in cultures made from normal and pathological lymph nodes in auto and homoplasma showed no differences.
Tackling coronary heart disease
Authors: A. White, L. Lockyer
Journal: BMJ (2001)

Coronary heart disease is the commonest cause of death in the United Kingdom, with marked gender differences in incidence, presentation, referral, recovery, and rehabilitation.1–6 Current policy on coronary heart disease is written in gender neutral language at a time when treatment has been moving towards a more behavioural model, where cardiac rehabilitation is a therapeutic option and changing cardiac health behaviour a major objective. Given the importance of this there is a need for health strategy that is gender sensitive.

The government views the national service framework for coronary heart disease as its “blueprint” for tackling heart disease.7 It lays out 12 standards and sets out services that should be available throughout England. Although the framework acknowledges gender differences, there is no clear recognition in the guidelines of how these are to be addressed.

In part this is due to …
Difference between young and old patients in characteristics of leukemic cells: Older patients have cells growing excessively in vitro, with low antigenicity despite high HLA-DR antigens
Authors: Nicos Giannoulis, Claudio Ogier, Robert Hast, Bertil Lindblom, Ann‐Marie Sjögren, Peter Reizenstein
Journal: American Journal of Hematology (1984)

Abstract Fifty‐six patients with acute, nonlymphatic leukemia in the initial phase were studied. The poor prognostic signs were excessive in vitro growth, many HLA‐DR‐positive cells, or a low ratio of leukemic cell antigenicity to HLA‐DR positivity and age. The cells from older patients formed more clusters (P &lt; 0.05), and they had less capacity to stimulate normal allogeneic lymphocytes (P &lt; 0.05) than those from younger patients. Cells forming many clusters also were more often (P &lt; 0.01) HLA‐DR‐positive than those forming few clusters. It is suggested that the prognosis in old patients with acute leukemia is poor in part because their leukemic cells have characteristics different from those of young patients.
Echocardiography in Diagnostic Assessment of Stroke
Authors: Philip Greenland, David S. Knopman, Frank L. Mikell, Richard W. Asinger, David C. Anderson, David C. Good
Journal: Annals of Internal Medicine (1981)

We assessed the use of echocardiography in the evaluation of stroke by recording M-mode and two-dimensional (2D) echocardiograms in 100 consecutive hospitalized patients. Of the 95 persons satisfactorily imaged with 2D echocardiography, 47 lacked clinical and routine laboratory evidence of heart disease; no potential embolic source or other finding that altered therapy was diagnosed by echocardiography. In the remaining 48 patients with clinical or routine laboratory evidence of heart disease, two with left ventricular thrombus as a potential embolic source were identified by 2D echocardiography. M-mode echocardiograms failed to detect the thrombus in either patient. No patients with left atrial thrombi, mitral stenosis, cardiac tumor, or vegetations suggesting endocarditis were identified. One patient had possible mitral valve prolapse. Echocardiograms in patients lacking other available evidence of heart disease are unlikely to yield findings that alter the clinical approach to patients with stroke; echocardiography in stroke patients with clinically evident heart disease may have greater clinical utility; additional study of the role of echocardiography in selected subgroups of stroke patients is indicated.
The Double Edge of Knowledge
Authors: Donald M. Berwick
Journal: JAMA (1991)

Sometimes learning requires courage. It can be difficult for experts, especially, to admit candidly that they could be better at what they do if only they knew more. To become a learner is to become vulnerable. The vulnerability is greater—and so, therefore, must be the courage—when accusation and fear are widespread. Under the threat of punishment or ridicule, normal people are more likely to defend themselves than to stretch themselves. Why take the risk of voluntarily admitting a need to learn more when that very admission can be used to hurt me? The dilemma is painful. On the one hand, improvement depends on learning from information about performance. Yet, on the other hand, that same information can easily be used to make and enforce judgments that provoke fear and prevent learning. In many arenas, American culture seems addicted to forms of surveillance, measurement, comparison,
Effects of Chloroquine on Patients with Cutaneous Porphyria of the "Symptomatic" Type
Authors: G. D. Sweeney, S. J. Saunders, E. B. Dowdle, L. Eales
Journal: BMJ (1965)

<h3>Background</h3> Hyperprolactinaemia is a common adverse effect of antipsychotics (APs). The results of Peony-Glycyrrhiza decoction (PGD) as a potentially useful adjunctive treatment for hyperprolactinaemia are inconsistent. <h3>Aim</h3> This meta-analysis of randomised controlled trials (RCTs) examined the efficacy and safety of adjunctive PGD therapy for AP-induced hyperprolactinaemia. <h3>Methods</h3> English (PubMed, Embase, Cochrane Library, PsycINFO) and Chinese (Chinese National Knowledge Infrastructure, Wanfang Data) databases were systematically searched up to 10 June 2018. The inclusion criteria were based on PICOS—<i>P</i>articipants: adult patients with schizophrenia; <i>I</i>ntervention: PGD plus APs; <i>C</i>omparison: APs plus placebo or AP monotherapy; <i>O</i>utcomes: efficacy and safety; <i>S</i>tudy design: RCTs. The weighted mean difference (WMD) and risk ratio (RR) along with their 95% CIs were calculated using Review Manager (RevMan) V.5.3 software. <h3>Results</h3> Five RCTs (n=450) were included and analysed. Two RCTs (n=140) were double-blind and four RCTs (n=409) reported ‘random’ assignment with specific description. The PGD group showed a significantly lower serum prolactin level at endpoint than the control group (n=380, WMD: −32.69 ng/mL (95% CI −41.66 to 23.72), <i>p</i>&lt;0.00001, <i>I</i><sup><i>2</i></sup>=97%). Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale (n=403, WMD: −0.62 (95% CI −2.38 to 1.15), <i>p</i>=0.49, <i>I</i><sup><i>2</i></sup>=0%). There were similar rates of all-cause discontinuation (n=330, RR 0.93 (95% CI 0.63 to 1.37), <i>p</i>=0.71, <i>I</i><sup><i>2</i></sup>=0%) and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from ‘very low’ (14.3%), ‘low’ (42.8%), ‘moderate’ (14.3%), to ‘high’ (28.6%). <h3>Conclusions</h3> Current evidence supports the adjunctive use of PGD to suppress elevated prolactin and improve prolactin-induced symptoms without significant adverse events in adult patients with AP-induced hyperprolactinaemia. High-quality RCTs with longer duration are needed to confirm these findings. <h3>Trial registration number</h3> 42016037017.
Reverse Perfusion Pattern of Tc-99m MIBI Heralding the Development of Myocardial Infarction
Authors: GABRIELE FRAGASSO, SERGIO L. CHIERCHIA, FLAVIANO DOSIO, GIUSEPPE PIZZETTI, LUIGI GIANOLLI, FERRUCCIO FAZIO
Journal: Clinical Nuclear Medicine (1996)

In a patient with sporadic atypical chest pain associated with dyspnea, stress Tc-99m MIBI imaging showed normal perfusion and inferoposterior hypoperfusion on the resting study. Although this reverse perfusion pattern was considered artifactual, the patient later had an acute myocardial infarction involving the same areas. Postinfarction stress Tc-99m MIBI imaging showed a nonreversible defect in the same area that, in the earlier study, showed a reverse perfusion pattern. The authors hypothesize that partial stenosis of the related artery with some nontransmural myocardial necrosis at the time of the initial study may be a possible cause of this peculiar Tc-99m MIBI perfusion pattern.
Human mesenchymal stem cells are recruited to injured liver in a β1-integrin and CD44 dependent manner
Authors: Victoria Aldridge, Abhilok Garg, Nicholas Davies, David C. Bartlett, Janine Youster, Heather Beard, Dean P. Kavanagh, Neena Kalia, Jon Frampton, Patricia F. Lalor, Philip N. Newsome
Journal: Hepatology (2012)

Human bone marrow mesenchymal stem cells (hMSCs) have shown benefit in clinical trials of patients with liver disease. Efficient delivery of cells to target organs is critical to improving their effectiveness. This requires an understanding of the mechanisms governing cellular engraftment into the liver. Binding of hMSCs to normal/injured liver tissue, purified extracellular matrices, and human hepatic sinusoidal endothelial cells (HSECs) were quantified in static and flow conditions. To define the mechanisms underpinning hMSC interactions, neutralizing adhesion molecule antibodies were used. Fluorescently labelled hMSCs were infused intraportally into CCl(4) -injured mice with and without neutralizing antibodies. hMSCs expressed high levels of CD29/β1-integrin and CD44. Using liver tissue binding assays, hMSC adhesion was greatest in diseased human liver versus normal liver (32.2 cells/field versus 20.5 cells/field [P = 0.048]). Neutralizing antibodies against CD29 and CD44 reduced hMSC binding to diseased liver by 34% and 35%, respectively (P = 0.05). hMSCs rolled at 528 μm/second on HSECs in flow assays. This rolling was abolished by CD29 blockade on hMSCs and vascular cell adhesion molecule-1 (VCAM-1) blockade on HSECs. Firm adhesion to HSECs was reduced by CD29 (55% [P = 0.002]) and CD44 (51% [P = 0.04]) blockade. Neutralizing antibodies to CD29 and CD44 reduced hepatic engraftment of hMSCs in murine liver from 4.45 cells/field to 2.88 cells/field (P = 0.025) and 2.35 cells/field (P = 0.03), respectively. hMSCs expressed modest levels of chemokine receptors including CCR4, CCR5, and CXCR3, but these made little contribution to hMSC adhesion in this setting. hMSCs bind preferentially to injured liver. Rolling of hMSCs is regulated by CD29/VCAM-1, whereas CD29/CD44 interactions with VCAM-1, fibronectin, and hyaluronan on HSECs determine firm adhesion both in vitro and in vivo as demonstrated using a murine model of liver injury.
Reporting AIDS in New York City-Reply
Authors: Mary Ann Chiasson
Journal: JAMA (1994)

<h3>In Reply.</h3> —Smith et al raise an important question regarding the origin of case reports in our study. Among patients of 14 private physicians who participated in our study, completeness of AIDS case reporting was 88%, but those patients reported had likely required hospital care and were reported through New York City's hospital-based AIDS surveillance network. This is an active surveillance system in which health department staff routinely contact hospitals. The system does not depend on physician-initiated reporting, which is historically much less complete.<sup>1,2</sup> Regarding our assessment of completeness of reporting by hospitals, Smith et al are correct that we intentionally used a conservative method to calculate completeness. Nevertheless, reporting by hospitals is likely less complete in New