tbuckley/cabot-search huggingface dataset:
Time to consider employment conditions for carers
Authors: Cynthia M Lewis
Journal: BMJ (2005)

Managing chronic diseases Palliative care spectrum starts early onEditor-Palliative care does not start when a patient is dying. 1 A whole spectrum of palliation begins from the day of diagnosis of a potentially terminal disease, such as soft tissue sarcoma.Palliation, in the sense of needing to absorb what this means for the patient, becomes even then a medical imperative.The "How long have I got, Doc?" question may not be articulated, but it will be there and needs an empathetic response.Curative treatment is sought, but-with sarcoma-lung metastases signal the end of that phase and the beginning of palliative treatment.The doctor and the patient know the dragon can be disabled but never slain.Palliation is then partnership, working to decide what may be gained at what cost.(This may apply during curative treatment: to take chemotherapy drugs now "just in case," or to keep them for later?)Palliative treatment can be long (in sarcoma up to 20 years or more), or it can be brief.Its ending is not solely a medical judgment.Doctors may decide they can do no more, but active patients use online support groups, seeking new treatment options across the world.Patients may decide to end palliative treatment.Grown weary of painful chemotherapy offering diminishing returns, they may prefer a shorter but better life.Making that choice together is an aspect of palliation.When death is near, palliative care becomes terminal care.If throughout doctors and patients have aligned their understanding of the disease, and have taken decisions jointly, have explored the holistic meaning of disease in life and death, the palliative spectrum may offer healing if not cure.If, however, being palliative begins only when the patient is dying doctors cannot then meet patients, where they are most needed, in the ground of their being and their not being.
A Report on the Disinfection of Tubercle-Infected Houses
Authors: S. Delepine, A. Ransome
Journal: BMJ (1895)

JOURNAL of November 4th, 1893, we gave an account of the origin of the present inquiry, its first object being to test the value of the method then used by the municipality of Manchester for disinfecting rooms in which tuberculous patients had lived.TABLE I.-Virulence of Fresh Human Tuberculous Sputum in
Relationship Between Functional Preservation after Segmentectomy and Volume-Reduction Effects after Lobectomy in Stage I Non-small Cell Lung Cancer Patients with Emphysema
Authors: Kosuke Kashiwabara, Ji-Ichiro Sasaki, Tsuyoshi Mori, Hiroaki Nomori, Kazuhiko Fujii, Hirotsugu Kohrogi
Journal: Journal of Thoracic Oncology (2009)
SAT0560 The in Vivo Role of Bone Specific Ephb4 Receptor Overexpression in Osteoarthritic Synovial Membrane
Authors: G. Valverde-Franco, D. Hum, B. Lussier, K. Matsuo, J.-P. Pelletier, M. Kapoor, J. Martel-Pelletier
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Osteoarthritis (OA) is characterized by progressive joint destruction including synovial membrane inflammation and abnormalities including fibrosis. Members of the Eph/ephrin family, the EphB4 receptor and its specific ligand ephrin-B2, were found to positively impact the abnormal structure and metabolism of OA subchondral bone and cartilage<sup>(1,2)</sup>. An in vivo study<sup>(3)</sup> on overexpression of EphB4 in bone demonstrated a protective effect on the subchondral bone and cartilage during OA. <h3>Objectives</h3> We further investigated, in vivo, the effect of bone-specific EphB4 overexpression on synovial membrane during OA. <h3>Methods</h3> Knee OA was surgically induced by destabilization of the medial meniscus (DMM) in 10-week-old male bone-specific EphB4 homozygous (TgEphB4) and wild-type (WT) mice. Synovial membrane evaluation was performed at 12 weeks post-surgery using histology and immunohistochemistry. Factors including fibrotic markers and signaling molecules were determined by real-time PCR, immunohistochemistry, and Western blot. <h3>Results</h3> Data demonstrated a significant decrease in synovial membrane thickness (p≤0.02), pro-collagen type I (p≤0.01), and fibrin (p≤0.04) in DMM-TgEphB4 compared to DMM-WT. The expression levels of the fibrotic markers connective tissue growth factor (CTGF, p≤0.02), smooth muscle actine α (SMAα, p≤0.03) and serum cartilage oligomeric matrix protein (COMP, p≤0.03) were significantly reduced in DMM-TgEphB4 compared with DMM-WT. Although TGF-β was decreased in the DMM-TgEphB4 mice, the difference did not reach statistical significance. However, the level of TGF-β signaling profibrotic members, TGFR1/ALK1, pSmad-1 and a member of the heat shock protein family, HSP90β, known to play a crucial role in enhancing TGF-β signaling, were all significantly decreased (p≤0.04) in DMM-TgEphB4. <h3>Conclusions</h3> This is the first in vivo evidence that protecting the subchondral bone prophylactically reduces the severity of structural and pathological changes in the synovial membrane during the OA process. Moreover, overexpression of bone-specific EphB4 in mice clearly demonstrated a downregulation of profibrotic members of TGF-β signaling in synovial membrane, thereby preventing the development and/or progression of fibrosis in this OA tissue. This study stresses the in vivo importance of subchondral bone structure/biology in OA joints. <h3>References</h3> Kwan Tat, S et al. Arthritis Rheum 2008:58:3820-30. Kwan Tat, S et al. Arthritis Res Ther 2009:11:R119. Valverde-Franco, G et al. Arthritis Rheum 2012:64:3614-25. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2277
Zimbabwe s public sector doctors temporarily return to work
Authors: P. Sidley
Journal: BMJ (2004)

The prolonged battle in Zimbabwe between public sector doctors and the government seems to be over, for the time being, after doctors returned to work last week.

But health troubles in the country are far from over. Nurses have also been on strike, and the country's largest nursing college failed to open last week when only a handful of tutors, also in search of more money, turned up for work.

Private sector doctors have also hiked up their fees. They are demanding …
Russian-English Biological Dictionary
Authors: S. S. B. Gilder
Journal: BMJ (1964)

emphasis on current problems in the patient's life situation.They illustrate with the help of four dreams how they proceed in their interpretations.The book is of great interest to everybody engaged in psychoanalysis and in psychotherapy on analytical lines.It is worthy of note that the mental processes which go into the interpretation of dreams have much in common with those which make up medical diagnosis and any kind of detec- tion where both intuition and reasoning are required.E. STENGEL.
Haemophilus influenza type b resistant to both chloramphenicol and ampicillin in Britain.
Authors: P Macmahon, J Sills, E Hall, T Fitzgerald
Journal: BMJ (1982)

benoxaprofen damage was reduced; this may be due to a subclinical photosensitivity reaction, as occurs with onycholysis, which may not be associated with obvious sun sensitivity.It is not yet clear whether the hypertrichosis is simply secondary to the photosensitivity, as is seen in porphyria4 and when alopecia areata is treated with ultraviolet B or psoralen-ultraviolet A, or whether a different mechanism is entailed, as in hypertrichosis associated with minoxidil.5
Effects of Subretinal Injections of Indocyanine Green, Trypan Blue, and Glucose in Rabbit Eyes
Authors: Fernando M. Penha, Mauricio Maia, Michel Eid Farah, André H. Príncipe, Edna H. Freymüller, André Maia, Octaviano Magalhães, Ricardo L. Smith
Journal: Ophthalmology (2007)
A New Insight into the Formation of Osteolytic Lesions in Multiple Myeloma
Authors: Donald A. Glass, Millan S. Patel, Gerard Karsenty
Journal: New England Journal of Medicine (2003)

Multiple myeloma is a cancer in which immunoglobulin-producing plasma cells undergo clonal expansion. Its characteristic feature is the monoclonal, or M, spike, usually detectable in serum or urine by protein electrophoresis. Malignant plasma cells have complex chromosomal rearrangements, leading in many cases to the aberrant activation of gene expression. Some of these activated genes encode secreted factors that can modify the microenvironment of the tumor in a manner that favors its growth or promotes its ability to cause lesions in surrounding tissues. The mechanism of bone destruction, a feature of multiple myeloma, is the focus of the article by Tian . . .
Mutations in lipase H cause autosomal recessive hypotrichosis simplex with woolly hair
Authors: Liran Horev, Antonella Tosti, Irit Rosen, Klilah Hershko, Colombina Vincenzi, Krassimira Nanova, Alexander Mali, Tamara Potikha, Abraham Zlotogorski
Journal: Journal of the American Academy of Dermatology (2009)
Major Progress in Fuchs's Corneal Dystrophy
Authors: Alan F. Wright, Baljean Dhillon
Journal: New England Journal of Medicine (2010)

The expected outcomes of the almost 800 genomewide association studies of common biomedical traits that have been reported so far1 have rarely been made explicit but might include the identification of statistically robust genetic associations, the elucidation of the heritable nature of the traits, and some utility to biology or medicine, such as mechanistic dissection or clinical prediction of disease. So far, the results have met the first goal but have generally disappointed on the second and third ones,2 although it could be argued that the jury is still out.There are several problems. First, the great majority of genetic . . .
Such a Strange Lady: A Biography of Dorothy L. Sayers
Authors: Lester S. King
Journal: JAMA (1976)

Between the mid-20s and World War II, a handful of authors transformed the detective story into a special art form of great brilliance. Of the select handful of authors, Dorothy L. Sayers, creator of Lord Peter Wimsey, was perhaps the greatest. The relationships between authoress Sayers, her hero Wimsey, and the thinly fictional heroine Harriet Vane, are complex indeed. This biography is itself a sort of literary detective story, presenting the life of the authoress, her relationships to her friends, the genesis and development of her fictional characters, their decline, and her other interests. The book should be an outstanding biography of the year. Dorothy L. Sayers, daughter of a minister, was awkward, socially inept, possessed of a "loud voice and a marvelous brain." Slow in maturing, she achieved emotional stability through her writings. Undoubtedly, she became emotionally entangled with her main characters, falling in love with Lord Peter, and
Gray platelet syndrome in the elderly
Authors: Alain Berrebi, Abraham Klepfish, David Varon, Mordechai Shtalrid, Eliakim Vorst, Emanuel Nir, Judith Lahav
Journal: American Journal of Hematology (1988)

Abstract A 68‐year‐old male who suffered from thrombocytopenia and mild splenomegaly for 18 years was found to present agranular gray platelets on peripheral blood smear. Bone biopsy revealed a mild, diffuse, reticular fibrosis with no collagen, and electron microscopy of the platelets showed an absence of almost all the α‐granules. Platelet thrombospondin and fibronectin analysed by SDS‐polyacrylamide gel electrophoresis and Rocket immunoelectrophoresis were absent. Follow‐up of 4 years showed the same parameters with no evidence of active myeloproliferative or dysmyelopoietic disorders. Hemorrhagic diathesis was limited to ecchymoses and postprostatectomy bleeding, necessitating platelet transfusion. This led us to conclude that our patient probably had a constitutional primary α‐granule deficiency or gray platelet syndrome. This extremely rare defect has been described in less than 10 patients, all of them very young. Our observation shows that these patients may have a long, uneventful survival.
Magico-religious mercury exposure.
Authors: A P Wendroff
Journal: Environmental Health Perspectives (1997)

s Focus article, "Measuring Mercury" (1), which appeared in the August 1996 issue of EHP, contained a serious omission.Wheeler concentrated on methyl mercury and, to a lesser extent, ele- mental mercury in dental amalgams.He failed to mention the relatively recently described but extremely significant expo- sures to elemental mercury in ethnically Hispanic and Caribbean homes, conse- quent to its use for a variety of magico-religious and ethnomedical purposes (2-3).Such domestic use and presumed expo- sure has been documented in a number of published papers, as well as by research sponsored by the ATSDR (4-6) and the EPA (7).In fact, an ATSDR monograph specifically alerts clinicians to this exposure pathway: "Metallic mercury has been used by Mexican-Americans and Asian popula- tions in folk remedies for chronic stomach disorders and by Latin-American and Caribbean natives in occult practices" (4).This monograph was edited by Thomas Clarkson, who was interviewed by Wheeler, and who has long been aware of elemental mercury's domestic use.Similarly, the EPA's Kathryn Mahaffey, also interviewed, has been aware of domestic mercury exposure for some years, and the EPA issued a risk assessment document on cultural uses of mercury in 1993 (7).These mercury exposures are especially significant from an environmental health perspective because, in many cases, they are certain to be orders of magnitude greater than (methyl) mercury exposures from eating fish or from the leaching of mercury in amalgam fillings.Additionally, the mercury vapor released from mercury intentionally sprinkled on floors affects all occupants of contaminated homes, from the fetus to the elderly.Andrew Rowland, cited in "The Issue of Amalgams" (1), has been aware of domestic mercury exposure for several years.Rowland makes a call for more research on health effects of amalgam-mercury exposure.I make a similar call for research on magico-religious mercury exposure.If the environmental health research community continues to ignore magico-religious mercury exposure, its health effects will never be ascertained.
Pneumococcal Vaccine: Clinical Efficacy and Effectiveness
Authors: J. SANFORD SCHWARTZ
Journal: Annals of Internal Medicine (1982)

Streptococcus pneumoniae causes substantial morbidity and mortality. Incidence and severity are increased among populations with some chronic diseases. The currently available polyvalent polysaccharide vaccine induces antibody production among immunologically competent recipients against the 14 serotypes responsible for 80% of pneumococcal bacteremia in the United States. The vaccine is safe and has proved efficacious in clinical trials with healthy young men in epidemic conditions and in patients with sickle cell anemia. Similar trials in two other high-risk populations had inconclusive results. Decisions on vaccine use now largely rest on indirect evidence of efficacy derived from knowledge of disease incidence, severity, and antibody response to vaccination among patient groups. Findings of a literature review suggest vaccinating high-risk patients immunologically competent to produce homotypic antibodies in response to vaccination with polysaccharide antigen, while continuing investigation of disease incidence, severity, serotype distribution, and immunologic response among high-risk groups and postmarketing surveillance efforts among all vaccinated patients.
Thiomersal does not cause autism, US court finds
Authors: C. Dyer
Journal: BMJ (2010)

A claim that the mercury based preservative thiomersal used in some vaccines can cause autism has been decisively rejected by the US Court of Federal Claims as “scientifically unsupportable.”

The rulings in three test cases deal a blow to the third of three theories put forward by parents to link their children’s autism to vaccines.

Last year the court ruled against claims that the measles, mumps, and rubella (MMR) vaccine, which has never contained thiomersal, in combination with vaccines such as that for diphtheria, pertussis, and tetanus (DPT), which did contain the preservative, causes autism. A separate claim—that the MMR vaccine itself causes the disorder—was withdrawn by parents.

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Cardiac and Vascular Adaptation in Pediatric Patients with Chronic Kidney Disease
Authors: Mark M. Mitsnefes, Thomas R. Kimball, Janis Kartal, Sandra A. Witt, Betty J. Glascock, Philip R. Khoury, Stephen R. Daniels
Journal: Journal of the American Society of Nephrology (2005)

In children, cardiac abnormalities such as increased left ventricular mass (LVM) and diastolic dysfunction develop at the time of mild to moderate chronic renal insufficiency (CRI) and progress as renal function deteriorates. It was hypothesized that in this age group, vascular abnormalities develop early in the course of chronic kidney disease (CKD) in parallel with cardiac abnormalities and become more severe as end-stage disease is reached. Echocardiography and ultrasound of the carotid artery were performed on 44 patients with CKD stages 2 to 4 (CRI group), 16 patients who were on maintenance dialysis, and 35 healthy individuals. Carotid artery intima-media thickness (cIMT) was measured and distensibility and stiffness were calculated to assess carotid artery structure and function. Both the CRI and dialysis groups had greater cIMT, higher LVM index, and poorer diastolic function than the control subjects (<i>P</i> &lt; 0.0001). Children who were on dialysis had greater cIMT and higher LVM index than those with CRI (<i>P</i> &lt; 0.001) and greater arterial stiffness than both CRI patients and control subjects (<i>P</i> &lt; 0.001). Arterial compliance was similar in CRI and control subjects. In all patients with CKD (CRI and dialysis), increased calcium-phosphorus product predicted increased cIMT. Increased serum phosphorus and intact parathyroid hormone predicted increased arterial stiffness. Elevated intact parathyroid hormone was a predictor of increased LVM index and poor diastolic function. In dialysis patients, the cumulative dose of phosphate binders and calcitriol predicted abnormal vascular structure and function. It is concluded that vascular abnormalities are already present in children and adolescents during early stages of CKD; they are more severe in children who are on maintenance dialysis and are related to abnormal calcium-phosphorus metabolism.
A New Generation of Retroviral Producer Cells: Predictable and Stable Virus Production by Flp-Mediated Site-Specific Integration of Retroviral Vectors
Authors: R. Schucht, A.S. Coroadinha, M.A. Zanta-Boussif, E. Verhoeyen, M.J.T. Carrondo, H. Hauser, Dagmar Wirth
Journal: Molecular Therapy (2006)

We developed a new strategy that provides well-defined high-titer producer cells for recombinant retroviruses in a minimum amount of time. The strategy involves the targeted integration of the retroviral vector into a chromosomal locus with favorable properties. For proof of concept we established a novel HEK293-based retroviral producer cell line, called Flp293A, with a single-copy retroviral vector integrated at a selected chromosomal locus. The vector was flanked by noninteracting Flp-recombinase recognition sites and was exchanged for different retroviral vectors via Flp-mediated cassette exchange. All analyzed cell clones showed correct integration and identical titers for each of the vectors, confirming that the expression characteristics from the parental cell were preserved. Titers up to 2.5 x 10(7) infectious particles/10(6) cells were obtained. Also, high-titer producer cells for a therapeutic vector that encodes the 8.9-kb collagen VII cDNA in a marker-free cassette were obtained within 3 weeks without screening. Thus, we provide evidence that the precise integration of viral vectors into a favorable chromosomal locus leads to high and predictable virus production. This method is compatible with other retroviral vectors, including self-inactivating vectors and marker-free vectors. Further, it provides a tool for evaluation of different retroviral vector designs.
Sedative but not anxiolytic properties of benzodiazepines are mediated by the GABAA receptor α1 subtype
Authors: R. M. McKernan, T. W. Rosahl, D. S. Reynolds, C. Sur, K. A. Wafford, J. R. Atack, S. Farrar, J. Myers, G. Cook, P. Ferris, L. Garrett, L. Bristow, G. Marshall, A. Macaulay, N. Brown, O. Howell, K. W. Moore, R. W. Carling, L. J. Street, J. L. Castro, C. I. Ragan, G. R. Dawson, P. J. Whiting
Journal: Nature Neuroscience (2000)
AN ANALYSIS OF THERAPEUTIC ARTFULNESS
Authors: WALTER BROMBERG
Journal: American Journal of Psychiatry (1958)

The common factor in all psychotherapeutic relations is admittedly the emotional relation between therapist and patient. In scrutinizing this factor, we encountered artfulness, the application of scientific technology which involves certain psychologic overtones of extra-technical nature operating within the therapist. The elements constituting artfulness involve, on one hand, the psychology of the therapist, and on the other, the psychology of the therapeutic process itself. The operational complex, identified with artfulness, resides in the application of a skill, i.e., is extra-technical and applies to all healers whatever their original postulates, premises, or theories of psychotherapy. This complex involves essentially conative impulses and insinuates a sense of assurance to the therapist which invades his critical judgment toward the efficacy, the "science," of the theoretical foundation of his method. Successful therapy is initially recognized as dependent on the technology stemming from the scientific hypotheses advanced. Judgment concerning the scientific hypothesis which underlies every method of psychotherapy lies under the shadow of the operational complex which has been identified with artfulness. Later the efficacy of a treatment method diminishes: that degree of success, not attributable to the specific scientific theory and its technology, is recognized as due to artfulness. The intrusion of the conative influence and other unconscious forces—magical thinking, omnipotence fantasies, narcissistic satisfaction, symbolic expression, etc., bears on a scientific judgment of the method in question, e.g., the verification of interpretations in psychoanalytic treatment. To explain how therapy works at all in successful cases, one must accept the extra-technical elements involved. This is suggested as the most plausible way to explain successful therapy when conducted by workers who point to the most diverse scientific theories and formulations as a valid basis for their accomplishments.