tbuckley/cabot-search huggingface dataset:
Cuts are putting quality of care at risk, say NHS managers
Authors: A. Cole
Journal: BMJ (2013)

A growing number of local NHS managers in England believe that the quality of care in their organisation is worsening as the effects of the drive to make £20bn (€23bn; $31bn) in NHS efficiency savings begin to bite, says the latest quarterly monitoring survey by the health think tank the King’s Fund.

The survey looked at service performance between October and December 2012, and for the first time it questioned directors of adult social services as well as NHS finance directors.1 All the 48 finance directors who responded (of 143 who were invited) were confident that they would balance their books this financial year, …
Indications and outcome of surgery for pulmonary aspergilloma
Authors: R. el Oakley, M. Petrou, P. Goldstraw
Journal: Thorax (1997)

The indications and the outcome of surgery for pulmonary aspergilloma remain highly controversial. The short term and long term results of lung resection or cavernostomy in 24 patients with pulmonary aspergilloma are reported.The case notes of 27 consecutive patients referred for surgical assessment for pulmonary aspergilloma at the Royal Brompton Hospital over the last 14 years were reviewed. Patients were categorised into four classes according to their fitness for lung resection and the severity of their symptoms. Severe symptoms were defined as life threatening haemoptysis or other symptoms requiring more than one hospital admission. Class I (n = 1), fit individual with mild or no symptoms; class II (n = 17), fit individuals with severe symptoms; class III (n = 1), unfit individual with no symptoms; and class IV (n = 8), unfit individuals with severe symptoms. Two asymptomatic patients and one on an IVOX pump were not accepted for surgery. Lung resection was performed in all 17 patients with class II disease, comprising segmentectomy only in five patients, lobectomy and segmentectomy in seven, and a completion pneumonectomy in five patients. Cavernostomy was performed in seven patients with class IV disease.Surgery was often complicated by prolonged air leakage and infection of residual space. There was no operative mortality in the group treated by resection whereas two of those who underwent cavernostomy died in the early postoperative period. All survivors were followed up for a median of 17 months (range 1-72 months); 19 were alive and had no symptoms attributable to aspergilloma. Late recurrence occurred in two patients in the cavernostomy group. The only late death occurred in the resection group five months postoperatively and was attributed to end stage renal disease.Lung resection in selected patients with complicated aspergilloma can be performed with low operative mortality. Cavernostomy is associated with high mortality and morbidity and should therefore only be performed in patients with life threatening symptoms who are unfit for lung resection.
New Approaches to Using the Determination-of-Need Process to Contain Hospital Costs
Authors: W. M. Greenfield
Journal: New England Journal of Medicine (1983)

Staggering increases in the costs of providing hospital services have prompted a closer scrutiny of state cost-containment mechanisms. Two such mechanisms that exist in many state regulatory arsenals are rate-setting agencies and the determination-of-need process. This article addresses one way in which determination of need can be used more effectively as a cost-containment tool.Determination of need is the process by which states, often with federal assistance, seek to control expenditures on construction, renovation, and capital equipment and on major changes in services. Most states have some form of review system for these expenditures, since the existence of such a . . .
Duration of the inhibitory activity on histamine‐induced skin weals of sedative and non‐sedative antihistamines
Authors: M. Almind, A. Dirksen, N. H. Nielsen, U. G. Svendsen
Journal: Allergy (1988)

The inhibitory effect of orally administered dexchlorfeniramine (4 mg/day), cyproheptadine (8 mg/day), astemizole (20 mg/day), loratadine (40 mg/day) and terfenadine (120 mg/day) on the size of histamine‐induced weals was tested by skin prick test with histamine in an open study including 23 healthy individuals. The antihistamines were administered for 2 days in the nationally recommended therapeutic doses. For all drugs the maximal weal suppression with the dosage chosen was recorded the day after the last dosage, being 29% (for dexchlorfeniramine), 72% (for cyproheptadine), 50% (for astemizole), 62% (for loratadine), and 56% (for terfenadine) of the baseline value. For the drugs in the same order the duration of the inhibitory effect of the drugs after the last dose administered was between 3–4, 7–11, 17–28, 4–7, and 4–7 days, respectively.
Rheumatoid Arthritis and Psoriasis
Authors: M. d. G. Gribble
Journal: Annals of the Rheumatic Diseases (1955)

An association between rheumatoid arthritis and psoriasis has been thought to exist for the past 130 years, but its nature is still debatable.There are two main problems:(i) whether the two conditions coincide more frequently than can be explained by chance, (ii) whether psoriaticc arthritis" is a specific disease.COINCIDENCE OF THE Two CONDITIONS (i) Occurrence of Psoriasis amongst Rheumatoid Arthritis.The reports available in the English language from Scandinavia or from the U.S.A. are listed in Table l.Although few series are large, their uniformity is striking, and it appears that in both countries some 3 per cent. of all rheumatoid arthritics also suffer from psoriasis.Some of these authors also give the incidence of psoriasis in a control series; these estimates, together with those available for the general population, are shown in EnglandGeneral population
Relation of the Contractile Reserve of Hibernating Myocardium to Myocardial Structure in Humans
Authors: Sherif F. Nagueh, Issam Mikati, Donald Weilbaecher, Michael J. Reardon, Ghassan J. Al-Zaghrini, Duarte Cacela, Zuo-Xiang He, George Letsou, George Noon, Jimmy F. Howell, Rafael Espada, Mario S. Verani, William A. Zoghbi
Journal: Circulation (1999)

Background —Although dobutamine echocardiography (DE) is widely used to assess myocardial viability in humans, little is known about the relation between contractile reserve and myocardial structure. Methods and Results —We evaluated 20 patients with coronary disease (64±13 years old, ejection fraction 28±7.5%) with DE (up to 40 μg · kg −1 · min −1 ), rest-redistribution 201 Tl single photon emission CT, and quantitative angiography before bypass surgery. During surgery, patients underwent transmural myocardial biopsies (n=37) guided by transesophageal echocardiography to determine the extent of interstitial fibrosis and intracellular and interstitial proteins by histopathology and immunohistochemistry. Among the 37 segments biopsied, 16 recovered function as assessed 2 to 3 months later. Segments with postoperative functional recovery had more wall thickening at low-dose DE (28% versus 3%, P &lt;0.001), higher thallium uptake (69% versus 48%, P =0.03), and less interstitial fibrosis (2% versus 28%, P &lt;0.001). Quantitative angiographic parameters did not predict recovery of function. Segments with DE viability (contractile reserve and/or ischemia) had less fibrosis (2.7% versus 28%, P &lt;0.001), less vimentin and fibronectin (both P &lt;0.01), more glycogen ( P =0.016), and higher thallium uptake (64% versus 35.5%, P &lt;0.05) than those without viability. Viable segments by both DE and thallium had less fibrosis (1%) than those viable by 1 of the 2 techniques (9%) or not viable by both (28%, P =0.005). Thickening at low-dose DE correlated well with the extent of interstitial fibrosis ( r =−0.83, P &lt;0.01). Conclusions —Contractile reserve during DE correlates inversely with the extent of interstitial fibrosis and the amount of fibronectin and vimentin and directly with rest-redistribution thallium uptake.
Cost of the House-Officer Interview
Authors: JEOFFREY K. STROSS
Journal: Annals of Internal Medicine (1980)

Letters and Corrections1 May 1980Cost of the House-Officer InterviewJEOFFREY K. STROSS, M.D.JEOFFREY K. STROSS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-5-721_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In addition to bearing the escalating costs of tuition, books, and living, senior medical students spend substantial time and money in selecting house-officer training programs. Major shifts in the availability of training positions has resulted from changes in immigration laws, adoption of flexible and categorical programs, and the rapid growth of family practice. The number of available positions has decreased, whereas a rapid increase in the number of graduating students has led to intense competition in fields such as internal medicine.Senior students at the University of Michigan have been surveyed to quantify costs of interviewing. Sixty-nine...Reference1. GARDNERHERBSTMAN PB. Rites of fall: the costs and utility of the internship interview. J Med Educ. 1978;53:929-31. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JEOFFREY K. STROSS, M.D.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA comparison of the methods and criteria used by traditional and primary care internal medicine programs to select residents 1 May 1980Volume 92, Issue 5Page: 721-722 ePublished: 1 December 2008 Issue Published: 1 May 1980 PDF downloadLoading ...
OP20 * BLOOD SERUM AND CSF ANALYTES SHOW POTENTIAL FOR USE AS A DIAGNOSTIC BIOMARKER FOR LOW AND HIGH GRADE GLIOMA
Authors: P. Abel
Journal: Neuro-Oncology (2014)

INTRODUCTION: There is a need for a biomarker with high sensitivity and specificity to aid glioma diagnosis. Current methods of diagnosis are invasive with the diagnostic test requiring hospitalisation. A rapid diagnostic based upon blood serum and CSF samples would allow for a relatively non-invasive test and open up the possibility of screening for glioma METHOD: Serum from 110 high grade and 44 low grade glioma patients, were analysed along with 33 control sera from non-cancerous patients. CSF was also analysed from 8 high grade glioma patients taken with lumbar puncture. The analysis was performed using a luminex immunoassay measuring 36 cancer-associated analytes simultaneously. RESULTS: There were significant differences in several analytes between sera and CSF of glioma patients of low and high grade and non-cancerous control patients. These were Angiopoietin, Follistatin, FGF, G-CSF, sHER2neu, HGF, sIL-6R, Leptin, PDGF-BB, PECAM-1, Prolactin and sVEGFR-1. CSF level differences confirmed and correlated with serum level differences in the majority of cases. CONCLUSION: These results suggest that specific protein levels in different media can be used to detect and confirm a glioma diagnosis as well as to distinguish between low and high grade gliomas. There was an interesting up-regulation of several receptor analytes that may have masked the presence of their associated ligand indicating that a masking effect may be taking place for certain potential biomarkers.
Magnetic-controlled capsule endoscopy vs. gastroscopy for gastric diseases: a two-center self-controlled comparative trial
Authors: Wen-Bin Zou, Xiao-Hua Hou, Lei Xin, Jun Liu, Lu-Min Bo, Guan-Yu Yu, Zhuan Liao, Zhao-Shen Li
Journal: Endoscopy (2015)

We developed a novel magnetic-controlled capsule endoscopy (MCE) system for use in the human stomach. The aim of the current study was to compare the diagnostic accuracy of MCE with that of standard gastroscopy for gastric diseases.A total of 68 patients were enrolled in this self-controlled trial. Patients were evaluated by both MCE and gastroscopy. Gastroscopy was performed 4 – 24 hours after completion of the MCE examination.The positive percent agreement between MCE and gastroscopy was 96.0 %, and the negative percent agreement was 77.8 %. The overall agreement was 91.2 % with a kappa value of 0.765 (P < 0.001). A total of 68 pathological findings were detected, of which 53 were identified by both methods. The MCE and standard gastroscopy missed seven and eight findings, respectively.MCE showed a diagnostic accuracy similar to that of standard gastroscopy. These results suggest that MCE is a promising alternative to gastroscopy for noninvasive screening of gastric diseases.Clinical trial registration number: NCT01903629.
Thin-film hydration preparation method and stability test of DOX-loaded disulfide-linked polyethylene glycol 5000-lysine-di-tocopherol succinate nanomicelles
Authors: Xiaoyu Ai, Lu Zhong, Handong Niu, Zhonggui He
Journal: Asian Journal of Pharmaceutical Sciences (2014)

A novel redox-responsive PEG-sheddable copolymer of disulfide-linked polyethylene glycol 5000-lysine-di-tocopherol succinate (P5kSSLV) was designed and synthesized. Thin-film hydration method was used to prepare DOX-loaded P5kSSLV nanomicelle. To optimize the preparation technology, we investigate the effects of dosage, type of organic solvent, hydration temperature and time, and cryoprotectant on drug-loading content, encapsulation efficiency, particle size, and zeta potential. The mean particle size and zeta potential were determined by Zetasizer. The morphology of the P5kSSLV-DOX nanomicelles was visualized by transmission electron microscopy. The drug-loading content and encapsulation efficiency of P5kSSLV-DOX nanomicelle were investigated by UV. The drug-loading content, encapsulation efficiency, particle size, and zeta potential of the final optimized nanomicelles were 4.58%, 97.20%, 30.21 nm and −0.84 mV, respectively. In addition, the stability of nanomicelles was investigated, which included dilution stability and storage stability. The results showed that P5kSSLV-DOX nanomicelle had good dilution stability and storage stability at 4 °C. The preparation method of P5kSSLV-DOX nanomicelle with thin-film hydration method was practical and simple, which was valuable to be further studied.
Acquired von Willebrand syndrome: Features and management
Authors: Hiroshi Mohri
Journal: American Journal of Hematology (2006)

Acquired von Willebrand syndrome (AvWS) is not a well-known bleeding disorder among clinicians and is associated with various underlying diseases. The clinical manifestations are similar to congenital von Willebrand disease. Diagnosis is confirmed mainly by a decrease of ristocetin cofactor activity (vWF:RCo) and/or collagen binding activity (vWF:CBA) and by vWF multimeric analysis, usually with a selective loss of large multimers. Plasma von Willebrand factor propeptide (vWF:AgII) is a good marker of vWF synthesis. Various pathogenic mechanisms have been proposed, including development of autoantibodies to the von Willebrand factor (vWF), adsorption of vWF onto tumor cells or activated platelets, increase of vWF proteolysis, and mechanical destruction of vWF under high shear stress. Treatment of the underlying disorder may resolve AvWS. Desmopressin (DDAVP) is a first-line therapeutic option. Factor VIII/vWF concentrates and high-dose immunoglobulin infusions are reserved for patients unresponsive to DDAVP. Am. J. Hematol. 81:616–623, 2006. © 2006 Wiley-Liss, Inc.
The dynamics of herpesvirus reactivations during and after severe drug eruptions: their relation to the clinical phenotype and therapeutic outcome
Authors: T. Ishida, Y. Kano, Y. Mizukawa, T. Shiohara
Journal: Allergy (2014)

Abstract Background Drug‐induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms ( DIHS / DRESS ) and Stevens–Johnson syndrome ( SJS )/toxic epidermal necrolysis ( TEN ) represent contrasting poles of severe drug eruptions, and sequential reactivations of several herpesviruses have exclusively been demonstrated in the former. No previous studies, however, were extended beyond the acute stage. We sought to investigate whether herpesvirus reactivations could also be observed in SJS / TEN and beyond the acute stage of both diseases. Methods Patients with SJS ( n = 16), SJS / TEN overlap ( n = 2), TEN ( n = 10), and DIHS / DRESS ( n = 34) were enrolled. We performed a retrospective analysis of Epstein–Barr virus ( EBV ), human herpesvirus 6 ( HHV ‐6), and cytomegalovirus ( CMV ) DNA loads sequentially determined by real‐time polymerase chain reaction during a 2‐year period after onset. Results Persistently increased EBV loads were detected in SJS during the acute stage and long after resolution, but not in others. In contrast, high HHV ‐6 loads were exclusively detected in DIHS / DRESS during the acute stage. The dynamics of herpesvirus reactivation varied in DIHS / DRESS according to the use of systemic corticosteroids: While EBV loads were higher in patients not receiving systemic corticosteroids, CMV and HHV ‐6 loads were higher in those receiving them. Conclusions Distinct patterns of herpesvirus reactivation according to the pathological phenotype and to the use of systemic corticosteroids were observed during the acute stage and follow‐up period, which may contribute, at least in part, to the difference in the clinical manifestations and long‐term outcomes. Systemic corticosteroids during the acute stage may improve the outcomes in DIHS / DRESS .
EXPERIMENTS WITH RENNET AND ANTIRENENE.
Authors: JOSEPH McFARLAND
Journal: JAMA (1903)

In 1899 Morgenroth published a paper entitled  Antibody of Rennet, containing a description of certain work that he had done in support of Ehrlich's chemical theory of the toxin-antitoxin reaction. So far as I know, Morgenroth's work met with universal acceptance without having been subjected to experimental confirmation, nor did I think it worth while to confirm it or make any addition to what Morgenroth had found until the specific precipitates began to attract attention, when their study led me to experiment with antipeptone, antivenene and antirenene.  The antirenene was prepared solely for the purpose of securing the precipitate, but as I found it possessed the power of inhibiting the coagulant action of rennet on milk, I continued to investigate the subject until I found in it a confirmation of what Morgenroth had done, and found myself able to make a few additional contributions to the subject.
Childhood Complications of Nalidixic Acid
Authors: E. Everett Anderson
Journal: JAMA (1971)

A 5-year-old girl developed bilateral palsy of the sixth nerve and papilledema following administration of 43.5 gm of nalidixic acid over a 58-day period. The x-ray film of the skull, electroencephalogram, cerebral arteriogram, and ventriculogram were normal. When therapy with the drug was terminated, the papilledema rapidly resolved and lateral rectus function improved. Although nalidixic acid administration has been associated with increased intracranial pressure, to the best of our knowledge palsy of the sixth nerve and subsequent strabismus have not previously been described.
Regional Left Ventricular Systolic Function in Humans During Off-Pump Coronary Bypass Surgery
Authors: P. M. Brown, V. B. Kim, B. J. Boyer, R. M. Lust, W. R. Chitwood, J. R. Elbeery
Journal: Circulation (1999)

Controversy exists as to whether off-pump CABG with local occlusion results in clinically significant myocardial ischemia during the occlusion period. This study was undertaken to delineate the effects of transient local coronary artery occlusion on regional systolic function.Eight consenting patients undergoing left internal mammary to left anterior descending coronary artery (LAD) bypass were instrumented with a left ventricular pressure catheter and 2 subepicardial cylindrical ultrasonic dimension transducers placed in the minor axis dimension in the region served by the LAD. A digital sonomicrometer was used to collect data before, during, and after coronary occlusion from which percent systolic shortening and pressure-dimension loops were derived. Measuring devices were removed immediately after the final time point. All patients tolerated the procedure well, and there were no complications. Average duration of local occlusion needed for CABG was 15.9+/-4.4 minutes (range, 12 to 26 minutes). Local occlusion was associated with a decrease in peak systolic shortening from 5.8+/-0.8% to 1.8+/-0.8%. In all cases, function returned to baseline after restoration of flow. Pressure-dimension loops confirmed these findings and no evidence of diastolic creep. Linear repression analysis of degree of stenosis versus change in segmental shortening revealed a significant inverse correlation.Local occlusion of the LAD resulted in a transient decrease in myocardial function during occlusion with complete recovery during reperfusion. This change was less significant with increasing degrees of coronary stenosis. These data suggest that local occlusion is not associated with permanent myocardial injury but that ischemic changes do occur that may be clinically significant, especially in patients with lesser degrees of coronary stenosis.
A Linear Time Scale for Spatial Vectorcardiographic Data
Authors: J. A. ABILDSKOV, W. E. INGERSON, B. L. HISEY
Journal: Circulation (1956)

Spatial vectorcardiograms have certain advantages over electrocardiograms for study of the heart's electric activity. They also have a marked disadvantage in that temporal relations are difficult to represent. Many of the advantages of the spatial vectorcardiogram can be retained and temporal relations can be adequately represented by presenting vectorcardiographic data as simultaneous traces of spatial magnitude and orientation about 2 axes. Such records have been derived from electrocardiographic leads obtained with 2 systems of electrode placement. The information known to beclinically important in the electrocardiogram was present in easily accessible form in these records.
Nafazatrom-induced salvage of ischemic myocardium in anesthetized dogs is mediated through inhibition of neutrophil function.
Authors: M Bednar, B Smith, A Pinto, K M Mullane
Journal: Circulation Research (1985)

The effects of nafazatrom on leukocyte function in vitro and in vivo were related to its ability to salvage ischemic myocardium in an occlusion-reperfusion model of myocardial injury in the anesthetized dog. Nafazatrom (0.4-75 microM) produced dose-related inhibition in vitro of neutrophil aggregation, superoxide anion generation, arachidonic acid metabolism, and, to a lesser extent, the release of beta-glucuronidase. In contrast, nafazatrom (0.4-37.5 microM) did not substantially influence platelet aggregation or the platelet metabolism of arachidonic acid. In vivo nafazatrom (10 mg/kg, po) reduced infarct size from 58 +/- 3% of the risk area (mean +/- SEM, n = 9) in control dogs to 23 +/- 2% of the risk area (n = 9, P less than 0.01). Nafazatrom also reduced the incidence of accompanying arrhythmias. Nafazatrom-induced myocardial salvage was not associated with any hemodynamic changes; moreover, it was independent of platelets, since thrombocytopenia did not prevent nafazatrom from exerting a protective effect. Measurements of the neutrophil-specific myeloperoxidase enzyme in ischemic myocardium indicate that the smaller infarct size in dogs treated with nafazatrom is accompanied by diminished leukocyte infiltration. Thus, the ability of nafazatrom to inhibit neutrophil function in vitro and cell infiltration in vivo may underly its myocardial-protective effects.
p53/p66Shc-mediated signaling contributes to the progression of non-alcoholic steatohepatitis in humans and mice
Authors: Kengo Tomita, Toshiaki Teratani, Takahiro Suzuki, Tetsuya Oshikawa, Hirokazu Yokoyama, Katsuyoshi Shimamura, Kiyoshi Nishiyama, Norikazu Mataki, Rie Irie, Tohru Minamino, Yoshikiyo Okada, Chie Kurihara, Hirotoshi Ebinuma, Hidetsugu Saito, Ippei Shimizu, Yohko Yoshida, Ryota Hokari, Kazuo Sugiyama, Kazuo Hatsuse, Junji Yamamoto, Takanori Kanai, Soichiro Miura, Toshifumi Hibi
Journal: Journal of Hepatology (2012)