tbuckley/cabot-search huggingface dataset:
Rosemary Pettersson (nee Atkinson)
Authors: M. Pettersson
Journal: BMJ (2009)

<h3>Introduction</h3> The inaugural South West leadership conference, ‘Next Generation Leaders’, was held in March 2019. This was open to 200 trainees and was jointly organised by the seven Health Education England South West (HEE-SW) Leadership Fellows and two Academic Foundation doctors. It was funded by HEE-SW through the Severn deanery in collaboration with the Leadership Academy. <h3>Issue</h3> The importance of good leadership skills in junior doctors is increasingly recognised; this conference aimed to inspire and equip clinicians with leadership skills. Topics included exploring leadership during challenging circumstances, leadership development, human factors and organisational structures. We adopted a distributive leadership approach, rapidly learning how to organise and promote a conference in budget, inviting speakers, providing network opportunities, website design and coordinating poster presentations. <h3>Intervention</h3> The conference delivered a varied programme with full details available at the event website (www.nextgenerationleaders.net). A diverse range of speakers were invited from within healthcare and other industries. We aimed for total inclusivity for all trainees across the South West, being free to access, central location and flexible content. <h3>Measurement</h3> Feedback from delegates was obtained via an electronic survey. Analysis showed the conference was well received, 98% of attendees recommended the conference. <h3>Lessons</h3> Reflections of the organising committee centred around how we worked as a team, bonding at the start of the fellowship and becoming a cohesive group. Through our individual and collective experiences this conference has acted as a catalyst to furthering our own leadership development inspiring us to pursue future opportunities. We would like to inform and inspire others interested in organising similar events. We hope to promote others to seek out leadership development opportunities, which is crucial for the future of the NHS.
NEW DIRECTIONS IN THE INPATIENT TREATMENT OF PSYCHOTIC CHILDREN IN A TRAINING CENTER
Authors: JOHN P. KEMPH, ALBERT C. CAIN, STUART M. FINCH
Journal: American Journal of Psychiatry (1963)

A review is presented of the treatment of 12 autistic and symbiotic psychotic children over a period of years at the Univesity of Michigan Children's Psychiatric Hospital. The paper focuses upon the effects of two contrasting treatment programs and their relation to problems specific to the treatment of these children in a training center. An initial group of 8 young psychotic children treated at the hospital showed relatively little improvement. Close scrutiny of the therapeutic program and course of their treatment revealed a number of potentially surmountable obstacles to these children's ego development. Subsequently, a group of 4 similar children were treated in a new, gradually evolved experimental program, with considerable improvement resulting. The new program included the use of multiple long-term therapists and group meeting for all personnel having close contact with these patients: it provided continuity of staff, coordination of treatment program, continual stimulation and reinforcement of the staff's therapeutic efforts, and generally diminished the likelihood of unchecked, malignant countertransference developments. Regularly scheduled group meetings for relevant personnel are in part educational but of greater significance is the group process which provides staff catharsis frequently and insight occasionally into their real feelings for these children. As a result the staff are less encumbered by negative countertransference. The staff members become mutually supportive when they share understanding of each others' efforts and sacrifices. Improvement in the autistic or symbiotic child is positively correlated with the total amount of the staff's sustained investment in his care, which can be enhanced by a staff "group."
C-11 Choline Versus F-18 Fluorodeoxyglucose for Imaging Meningiomas
Authors: Giampiero Giovacchini, Federico Fallanca, Claudio Landoni, Luigi Gianolli, Piero Picozzi, Luca Attuati, Mariarosa Terreni, Maria Picchio, Cristina Messa, Ferruccio Fazio
Journal: Clinical Nuclear Medicine (2008)

Purpose: Positron emission tomography/computed tomography (PET/CT) with C-11 choline has been used for staging, restaging, and follow-up of various tumors, whereas its role for imaging meningiomas has only been preliminarily explored. The aim of this study was to compare C-11 choline and F-18 fluorodeoxyglucose (F-18 FDG) uptake in meningiomas and relate these findings to the histopathological analysis. Methods: Two sequential three-dimensional PET/CT scans with 370 MBq (10 mCi) of C-11 choline and 370 MBq (10 mCi) of F-18 FDG were performed 2 hours apart in 7 patients with histologically confirmed meningiomas. Five patients had WHO grade I and 2 had WHO grade II meningioma. For each scan, two-dimensional regions of interest were drawn on tumor boundaries and on the contralateral side on CT images and copied to the corresponding PET images. SUVmax and tumor-to-background ratio were calculated. Results: Relative to the contralateral side, C-11 choline uptake was increased in all meningiomas, whereas F-18 FDG uptake was decreased in 6 patients and increased in 1 of the 2 patients with grade II meningiomas. In the whole group, SUVmax of C-11 choline and F-18 FDG were 3.6 ± 1.3 and 5.7 ± 1.3, respectively. The tumor-to-background ratio for C-11 choline was much higher than that for F-18 FDG (5.3 ± 0.8 vs. 0.9 ± 0.2, respectively) (P < 0.001). The uptake of C-11 choline was higher in patients with grade II than in grade I meningiomas. Conclusions: These preliminary results suggest that C-11 choline may better image meningiomas in comparison with F-18 FDG. Clinical applications of C-11 choline PET/CT for grading and follow-up of meningiomas need to be assessed in further studies.
Points from letters: GPs' work load
Authors: C Lipp
Journal: BMJ (1975)

NHS family planning services SIR,-In the BM7 (19 July, p 185) it is re- ported that "the profession's negotiators [our italics] and the DHSS have agreed a scheme for the provision of family planning services through the hospital service, for all FP work, whether of medical or social origin."We are astonished that there has been, as yet, minimal medical or public reaction to this retrograde proposal.It is the feeling of the undersigned staff of the obstetrical and gynaecological department in Aberdeen that this scheme is indisputably bad.The reasons for its introduction are far from obvious and the advantages in terms of patient care are difficult to define.Furthermore, it may turm out to have a dangerously disruptive effect among different grades of staff in many gynaecological and anaesthetic departments, including theatre staff and porters.It seems ludicrous for a health service short of money in a time of rapid inflation to put out extra money to its highest paid workers.This is all apart from the questionable morality of the scheme and the inevitable difficulties it will present in the counselling of patients who seek unbiased family planning advice.
Developmental Exposure to Polychlorinated Biphenyls Influences Stroke Outcome in Adult Rats
Authors: Suzan Dziennis, Dongren Yang, Jian Cheng, Kim A. Anderson, Nabil J. Alkayed, Patricia D. Hurn, Pamela J. Lein
Journal: Environmental Health Perspectives (2008)

The "developmental origins of adult disease" hypothesis was originally derived from evidence linking low birth weight to cardiovascular diseases including stroke. Subsequently, it has been expanded to include developmental exposures to environmental contaminants as risk factors for adult onset disease.Our goal in this study was to test the hypothesis that developmental exposure to poly-chlorinated biphenyls (PCBs) alters stroke outcome in adults.We exposed rats to the PCB mixture Aroclor 1254 (A1254) at 0.1 or 1 mg/kg/day in the maternal diet throughout gestation and lactation. Focal cerebral ischemia was induced at 6-8 weeks of age via middle cerebral artery occlusion, and infarct size was measured in the cerebral cortex and striatum at 22 hr of reperfusion. PCB congeners were quantified in brain tissue by gas chromatography with microelectron capture detection, and cortical and striatal expression of Bcl2 and Cyp2C11 were quantified by quantitative reverse transcriptase-polymerase chain reaction.Developmental exposure to A1254 significantly decreased striatal infarct in females and males at 0.1 and 1 mg/kg/day, respectively. Predominantly ortho-substituted PCB congeners were detected above background levels in brains of adult females and males exposed to A1254 at 1 but not 0.1 mg/kg/day. Effects of developmental A1254 exposure on Bcl2 and Cyp2C11 expression did not correlate with effects on infarct volume.Our data provide proof of principle that developmental exposures to environmental contaminants influence the response of the adult brain to ischemic injury and thus represent potentially important determinants of stroke susceptibility.
Germany's new charging system has mixed results
Authors: Annette Tuffs
Journal: BMJ (2004)

The number of patients in Germany seeking health care from their GPs or specialist practitioners was 15% lower in January 2004 than in the previous month. Health reforms, including charges to see a doctor, were introduced in Germany at the beginning of the year. However, in December 2003 practices were exceptionally busy as patients saw their doctors for treatment and prescriptions before the changes were introduced.

The decrease in visits in January was announced by Roland Stahl, speaker of the …
FRACTURE OF RIBS COMPLICATED BY ILEUS
Authors: D. T. Vandel
Journal: JAMA (1926)

Fracture of the ribs is a common surgical condition, but rib fracture followed by ileus is a rarity worthy of note. J. B., a man, aged 43, admitted to the hospital, Oct. 22, 1925, had been in an automobile accident. Roentgen-ray examination showed a fracture of the twelfth rib in the right scapular line, and the eighth and ninth ribs 1 inch to the right of the vertebral margin. The right thorax was strapped with adhesive tape, and the patient was put to bed and made as comfortable as possible. Next day, severe lancinating pain in the epigastrium and right hypochondrium was relieved for about two hours by morphine. Later in the afternoon, he vomited moderate quantities of bile-stained fluid; enemas were without result. By this time, abdominal distention was marked, the pain was increasing in severity, and the patient became delirious. It was thought that a mesenteric thrombosis, traumatic
Metabolically inactive insulin analog prevents type I diabetes in prediabetic NOD mice.
Authors: D G Karounos, J S Bryson, D A Cohen
Journal: Journal of Clinical Investigation (1997)

The purpose of this study was to determine the relative importance of the metabolic effects of insulin for diabetes prevention by administering insulin or an inactive insulin analog by daily subcutaneous injections to prediabetic mice. A recombinant monomeric human insulin analog, which does not bind to the insulin receptor as a consequence of an alteration of a single amino acid at position 25 of the B chain, was shown to be equally effective at diabetes prevention as was intact insulin. In contrast to native insulin, the insulin analog did not cause hypoglycemia after subcutaneous injection. The insulin analog, however, protected young adult mice from diabetes, even when it was initiated after the onset of extensive lymphocytic infiltration of the islets. Thus, preventative therapy by daily subcutaneous injections of insulin does not require the hypoglycemic response, or binding to the insulin receptor to prevent the onset of type I diabetes.
Effect of the quality and outcomes framework on diabetes care in the United Kingdom: retrospective cohort study
Authors: M. Calvert, A. Shankar, R. J McManus, H. Lester, N. Freemantle
Journal: BMJ (2009)

<b>Objectives</b> To examine the management of diabetes between 2001 and 2007 in the United Kingdom and to assess whether changes in the quality of care reflect existing temporal trends or are a direct result of the implementation of the quality and outcomes framework. <b>Design</b> Retrospective cohort study. <b>Setting</b> 147 general practices (annual list size over 1 million) across the UK. <b>Patients</b> People with type 1 or type 2 diabetes. <b>Main outcome measures</b> Annual prevalence of diabetes and attainment of process and clinical outcomes over the three years before and the three years after the introduction of the quality and outcomes framework. <b>Results</b> Significant improvements in process and intermediate outcome measures were observed during the six year period, with consecutive annual improvements observed before the introduction of incentives. However, the current diagnostic case definition for the quality and outcomes framework does not capture up to two thirds of people with type 1 diabetes and a third of people with type 2 diabetes. After the introduction of the quality and outcomes framework, existing trends of improvement in glycaemic control, cholesterol levels, and blood pressure were attenuated, particularly in people with diabetes who did not meet the case definition of the quality and outcomes framework. The introduction of the quality and outcomes framework did not lead to improvement in the management of patients with type 1 diabetes, nor to a reduction in the number of patients with type 2 diabetes who had HbA<sub>1c</sub> levels greater than 10%. Introduction of the quality and outcomes framework may have increased the number of patients with type 2 diabetes with HbA<sub>1c</sub> levels of ≤7.5%; odds ratio 1.05 (95% confidence interval 1.01 to 1.09; P=0.02). <b>Conclusions</b> The management of people with diabetes has improved since the late 1990s, but the impact of the quality and outcomes framework on care is not straightforward; upper thresholds may need to be removed or targets made more challenging if people are to benefit. Many patients in whom care may be suboptimal may not be captured in the quality and outcomes framework assessment.
(3) Localized pemphigoid
Authors: G.P. Sparrow, E.J. Moynahan
Journal: British Journal of Dermatology (2006)

Journal Article (3) Localized pemphigoid Get access G.P. Sparrow, G.P. Sparrow Guy's Hospital, London Search for other works by this author on: Oxford Academic Google Scholar E.J. Moynahan E.J. Moynahan Guy's Hospital, London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 95, Issue s14, 1 December 1976, Pages 26–28, https://doi.org/10.1111/j.1365-2133.1976.tb07897.x Published: 01 December 1976
Sphenoid Sinus Mucocele
Authors: Jonathan H. Pincus, Robert B. Daroff
Journal: JAMA (1964)

MUCOCELE of the sphenoid sinus is an uncommon disorder. It has been estimated that less than 60 case reports have appeared in the world literature.<sup>1</sup>The etiology of the mucocele is not clear. It is said to be a retention cyst caused by obstruction of normal drainage from the sinus. The presence of a chronic low grade infection may be a causative factor.<sup>2</sup> As the mucocele expands, surrounding bony structures undergo osteoclastic absorption. If the necrosis of bone continues, pressure on dura and adjacent neural elements may produce neurological signs.<sup>3</sup> The present case study is of a patient who presented with a history and clinical picture suggestive of "ophthalmoplegic migraine." On investigation, a mucocele of the sphenoid sinus was found. <h3>Report of a Case</h3> A 47-year-old white man was admitted to the Grace-New Haven Community Hospital on April 2, 1963, with a chief complaint of drooping of
Human Th2 cells Produce IFN-gamma Due to Hyper-Expression of T-bet
Authors: O. Kaminuma, N. Kitamura, A. Mori, S. Nemoto, H. Tatsumi, H. Miyoshi, S. Miyatake, F. Kitamura, K. Yamaoka, T. Hiroi
Journal: Journal of Allergy and Clinical Immunology (2010)
CONTRIBUTION OF STUDENT HEALTH SERVICES TO PUBLIC HEALTH
Authors: J. HOWARD BEARD
Journal: JAMA (1922)

A health service is neither an institution of philanthropy nor an organization for the promotion of paternalism. It strives to cooperate, not to compete, with the medical profession. It augments rather than decreases the practice of local physicians. It has nothing to do with either compulsory health insurance or contract practice. It functions solely in the interest of sound economy by keeping the maximum number of students in the classroom and by insuring the investment in education by teaching elementary knowledge of the human machine, which each student must handle for the remainder of his life. It endeavors to keep the normal fit; to restore the ill quickly to health. Health, as defined by it, is not merely the absence of disease, but the sustained striving for physical, mental, and moral perfection—constructive, dynamic living in the best environment that modern science is capable of producing. Its purpose is to bring
Development of Self‐Assembling Mixed Protein Micelles with Temperature‐Modulated Avidities
Authors: Allyson S. C. Soon, Michael H. Smith, Emily S. Herman, L. Andrew Lyon, Thomas H. Barker
Journal: Advanced Healthcare Materials (2013)

Abstract Elastin‐like polypeptides (ELPs) are polypentapeptides that undergo hydrophobic collapse and aggregation above a specific transition temperature, T t . ELP diblocks sharing a common “core” block (I60) but varying “outer” blocks (A80, P40) were designed, where T t,I &lt; T t,A &lt; T t,P . The formation of ∼55 nm diameter mixed micelles from these ELP diblocks was verified using dynamic light scattering (DLS), multiangle light scattering (MALS) and fluorescence resonance energy transfer (FRET). To confer affinity to the blood circulating protein fibrinogen, a fibrinogen‐binding tetrapeptide sequence (GPRP) was fused to A80‐I60, while P40‐I60 was fused to a non‐binding control (GPSP). The self‐assembling, peptide‐displaying, mixed micelles exhibit temperature‐modulated avidities for immobilized and soluble fibrinogen at 32 °C and 42 °C. In this initial proof‐of‐concept design, the engineered mixed micelles were shown to disengage fibrinogen at elevated temperatures. The modular nature of this system can be used for developing in vivo depot systems that will only be triggered to release in situ upon specific stimuli.
Risk for Subsequent Cancer after Diagnosis of Basal-Cell Carcinoma: A Population-Based, Epidemiologic Study
Authors: Morten Frisch
Journal: Annals of Internal Medicine (1996)

Background: Considerable debate is taking place over whether patients with basal-cell carcinoma and other skin neoplasms are at increased risk for internal cancer. Objective: To investigate risk for subsequent cancer in patients with basal-cell carcinoma. Design: Population-based cohort study. Setting: Denmark, from 1978 to 1991. Patients: 37 674 patients followed for a maximum of 14 years after a first diagnosis of basal-cell carcinoma. Measurements: The occurrence of subsequent cancer was compared with the expected cancer pattern (which was determined on the basis of national incidence data). Standardized incidence ratios (SIRs), ratios of actual to expected number of cases of cancer, yielded estimates of the relative risk. Results: During 190 945 patient-years of follow-up, 3663 new cases of cancer occurred where only 3245 were expected. As anticipated, malignant melanoma occurred frequently (SIR, 2.64 [95% CI, 2.21 to 3.13]), but patients were also at increased risk for noncutaneous cancer (SIR, 1.19 [CI, 1.13 to 1.24] for men and 1.09 [CI, 1.03 to 1.16] for women). The excess risk for noncutaneous cancer pertained to cancer of the lip (SIR, 2.07), salivary glands (SIR, 2.45), larynx (SIR, 1.41), lung (SIR, 1.40), breast (SIR, 1.13), and kidney (SIR, 1.30) and non-Hodgkin lymphoma (SIR, 1.36). Patients receiving a diagnosis of basal-cell carcinoma before 60 years of age (SIR, 1.26) had a statistically higher risk for developing new cancer (P < 0.01) than did those receiving the diagnosis at 60 years of age or older (SIR, 1.11). This applied to breast cancer (SIR, 1.37 in patients <60 years of age compared with 1.05 in those ≥ 60 years of age), testicular cancer (SIR, 3.52 in patients <60 years of age compared with 0 seen and 1.96 expected in those ≥ 60 years of age), and non-Hodgkin lymphoma (SIR, 2.50 in patients <60 years of age compared with 1.16 in those ≥ 60 years of age). Conclusion: In addition to having an increased risk for new skin cancer, patients with basal-cell carcinoma have an increased risk for noncutaneous cancer at various sites. Increased risks for testicular cancer, breast cancer, and non-Hodgkin lymphoma should be kept in mind, particularly for patients in whom basal-cell carcinoma is diagnosed when they are at a young age.
Spontaneous Variability of Left Ventricular Outflow Tract Gradient in Hypertrophic Obstructive Cardiomyopathy
Authors: Ali M. Kizilbash, Sheila K. Heinle, Paul A. Grayburn
Journal: Circulation (1998)

Background —Improvement in the left ventricular outflow tract (LVOT) gradient has been used as a means of assessing response to therapy in patients with hypertrophic obstructive cardiomyopathy (HOCM). To our knowledge, no data exist regarding the spontaneous day-to-day variability of the LVOT gradient in patients with HOCM. Defining the magnitude of such variability is critical to properly understand how much improvement in LVOT gradient must be present to invoke a therapeutic response. Methods and Results —We studied the spontaneous variation in the continuous-wave, Doppler-derived pressure gradient on 5 consecutive days in 12 HOCM patients and 5 aortic stenosis control subjects. While in some patients the day-to-day variability in resting gradient was small, in others it varied markedly. The 95% confidence interval for attributing a change in LVOT gradient to factors other than random variation is ±32 mm Hg for resting gradient and ±50 mm Hg for provoked gradient. The mean coefficient of variation for gradient across 5 days for the group was 0.52±0.33 for resting gradient and 0.46±0.16 for provoked gradient. The day-to-day variability in pressure gradient could not be explained by changes in heart rate, blood pressure, or left ventricular end-diastolic dimension, each of which had a coefficient of variation &lt;.11. Moreover, technical factors related to the performance or interpretation of the studies did not account for it because the coefficient of variation for gradient in aortic stenosis was &lt;10% and interobserver and intraobserver agreement was excellent ( r =.96 and .98, respectively). Conclusions —The LVOT pressure gradient varies considerably from day to day in stable patients with HOCM. A single measurement of pressure gradient is not adequate to define the severity of dynamic LVOT obstruction in HOCM.
Ceruloplasmin in Wilson's Disease*
Authors: Neil A. Holtzman, Michael A. Naughton, Frank L. Iber, Bonnie M. Gaumnitz
Journal: Journal of Clinical Investigation (1967)

Ceruloplasmin was highly purified from one patient with Wilson's disease and partially purified from a second unrelated patient. The highly purified ceruloplasmin was indistinguishable from normal ceruloplasmin by electrophoresis, tryptic peptide map, oxidase activity, and copper, amino acid, and sugar composition. The partially purified ceruloplasmin was indistinguishable electrophoretically from normal ceruloplasmin. With penicillamine therapy, ceruloplasmin disappeared from the serum of the first patient; it reappeared after the drug was discontinued. The significance of this observation in regard to the basic defect in Wilson's disease is discussed.