tbuckley/cabot-search huggingface dataset:
More money for training?
Authors: C. Bulstrode, J. Lourie
Journal: BMJ (1997)

Sociologically, hospital doctors are members of craft guilds. Consultants (the masters of these guilds) control their craft through the royal colleges. The junior doctors are their apprentices. Unfortunately the master/apprentice model has always been open to abuse. It is in the master's interest to extend the length of the apprenticeship. This enhances the status of the guild, holds down the number of masters, and maintains a comfortably closed shop. In Britain between the 13th and 15th centuries the length of an apprenticeship rose from seven to 16 years, and finally had to be cut back by royal statute.

Length of apprenticeship still continues as a problem in hospital medicine in the late 20th century. Consultants have been taking 10 or more years in specialty training to achieve accreditation. This is far longer than necessary, if training is the only factor involved. The problem now (as it was no doubt in the 14th century) is that the large numbers of apprentices have become the backbone of the service. The reduction in junior doctors' hours, combined with the reduction in length of training, is bringing about a staffing crisis in …
Why sports injuries clinics?
Authors: P N Sperryn, J G Williams
Journal: BMJ (1975)

Sport for all" means sports injuries for all. Facilities for their treatment are inadequate in the United Kingdom. An analysis of 1750 cases indicated that many injuries are specific to sporting activity and that the problem of their treatment cannot effectively be solved by the organization of special clinics for sportsmen based on existing services. There is a case for establishing regional or area clinics manned by appropriately trained, recognized, and committed specialists.
Leukemogenic mechanisms and targets of a NUP98/HHEX fusion in acute myeloid leukemia
Authors: Dragana Jankovic, Paolo Gorello, Ting Liu, Sabire Ehret, Roberta La Starza, Cecile Desjobert, Florent Baty, Martin Brutsche, Padma-Sheila Jayaraman, Alessandra Santoro, Christina Mecucci, Juerg Schwaller
Journal: Blood (2008)
Abstract P6-07-02: Prediction of onco<i>type</i> DX® recurrence score using pathology generated equations
Authors: R Bhargava, ME Klein, Y Shuai, AM Brufsky, SL Puhalla, R Jankowitz, DJ Dabbs
Journal: Cancer Research (2012)

Abstract BACKGROUND: Oncotype DX® is a quantitative reverse transcription polymerase chain reaction based assay that has been shown to have prognostic and predictive value in estrogen receptor (ER) positive breast cancers. The result is reported as a recurrence score (RS) ranging from 0–100, divided into low risk (&amp;lt;18), intermediate risk (18–30), and high risk (≥31) categories. Prior studies have shown that RS is influenced by ER and progesterone receptor (PR) expression, HER2 status, proliferation index, and tumor grade. Our pilot study showed that RS can be predicted by an equation incorporating standard morpho-immunohistologic variables (referred to as Original Magee Equation; Mod Pathol. 2008;21:1255–1261). METHODS: Using a dataset of 817 cases, we formulated three additional equations to predict the RS category for an independent set of 255 cases. Three models were built based on different hypotheses and data availability and are represented below. New Magee Equation 1 (nME1): RS = 15.31385 + Nottingham score*1.4055+ ER H-score*(−0.01924) + PR H-score*(−0.02925) + (0 for HER2 negative, 0.77681 for equivocal, 11.58134 for HER2 positive) + Tumor size*0.78677 + KI67 index*0.13269. New Magee Equation 2 (nME2): RS = 18.8042+ Nottingham score*2.34123 + ER H-score*(−0.03749) + PR H-score*(−0.03065) + (0 for HER2 negative, 1.82921 for equivocal, 11.51378 for HER2 positive) + Tumor size*0.04267. New Magee Equation 3 (nME3): RS = 24.30812+ ER H-score*(−0.02177) + PR H-score*(−0.02884) + (0 for HER2 negative, 1.46495 for equivocal, 12.75525 for HER2 positive) + KI-67*0.18649. RESULTS: The concordance between the risk category of oncotype DX® and our equations was 55.8%, 59.4%, and 54.4% for nME1, nME2, and nME3 respectively. With exclusion of the intermediate risk categories for both the actual RS and estimated RS, the concordance for each equation increased to more than 95%, reflecting the very low two step discordance (100% {76/76}, 98.6% {75/76}, and 98.7% {79/80} for nME1, nME2, and nME3 respectively). Even when the estimated RS fell in the intermediate category with any of the equations, the actual RS was either intermediate or low in more than 85% of the cases. The Pearson correlation coefficient between estimated and actual RS was similar for each of the equations (0.61661, 0.60386 and 0.59407 for nME1, nME2 and nME3, respectively). CONCLUSIONS: Any of the 3 equations can be used to estimate the RS depending on available data. If the estimated RS is clearly high or low, the oncologists should not expect a dramatically different result from oncotype DX®, and the oncotype DX® test may not be needed. Conversely, an oncotype DX® result that is dramatically different from what is expected based on standard morpho-immunohistologic variables should be thoroughly investigated. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-07-02.
Ultrafiltration of lipoproteins through a synthetic membrane
Authors: Clark K. Colton, Sigmund Friedman, Dana E. Wilson, Robert S. Lees
Journal: Journal of Clinical Investigation (1972)

To investigate the interaction of lipoproteins with semipermeable membranes, solutions of low density lipoproteins (LDL), very low density lipoproteins (VLDL), mixtures of the two, and diluted, normal, and hyperlipidemic serum were ultrafiltered through a synthetic membrane (500 A nominal pore diameter) using a stirred laboratory ultrafiltration cell. The pressure dependence of ultrafiltrate flux showed that a concentrated layer of lipoproteins was built up at the membrane surface (concentration polarization) and that VLDL was more subject to polarization than LDL. This phenomenon controlled the observed lipoprotein transport behavior. Whereas true membrane rejection (the fraction of the solute on the membrane surface which does not pass through the membrane) was greater than 0.95 for both LDL and VLDL, observed solute rejection varied from nearly 0 to 1.0, depending upon experimental conditions. If concentration polarization occurs in the arterial system, these results suggest that lipoprotein transport into arterial wall may be influenced not only by arterial blood pressure and the properties of the arterial wall, but also by local hemodynamic conditions and by the relative as well as absolute magnitudes of LDL and VLDL concentration.
<i>Chlamydia pneumoniae</i> Infection Does Not Induce or Modify Atherosclerosis in Mice
Authors: Giuseppina Caligiuri, Martin Rottenberg, Antonino Nicoletti, Hans Wigzell, Göran K. Hansson
Journal: Circulation (2001)

Background —Seroepidemiological studies have linked Chlamydia pneumoniae (CP) to coronary heart disease, and recent experimental studies suggest that it may accelerate or even induce atherosclerosis. We therefore evaluated the effect of CP infection on atherosclerosis in atherosclerosis-prone apolipoprotein E–knockout (apoE-KO) and wild-type C57BL/6J mice. Methods and Results —Six- to 8-week-old female mice were infected intranasally with live CP and then fed a standard chow diet for 22 weeks. A subgroup of mice was reinfected 18 weeks after primary infection. Polymerase chain reaction analysis of lung tissue confirmed successful infection with CP, and ELISA assays demonstrated development of a humoral immune response. Despite this, no statistically significant differences in aortic atherosclerotic lesions were found between CP-infected and control apoE-KO mice. Furthermore, CP infection did not induce atherosclerosis in C57BL/6J mice. Conclusions —CP does not induce atherosclerosis in wild-type mice and does not accelerate atherosclerosis in chow-fed apoE-KO mice. Further studies will be necessary to clarify the explanation for the seroepidemiological association between CP and coronary heart disease in humans.
Diagnostic Value of Brain Scanning in Children
Authors: Peter J. Hurley
Journal: JAMA (1972)

To assess the diagnostic value of brain scanning in pediatrics, results in 556 children were analyzed. Follow-up data were available in 409 children. Of these, 37% had brain scans done because of seizures; other frequent indications were motor abnormalities (7.4%), headache (5.0%), suspected optic neuritis (4.9%), raised intracranial pressure (4.9%), and trauma (4.7%). Fifteen percent of the scans were abnormal, most often because of tumors of the brain, pituitary fossa, brain stem, and cerebellum; subdural collections; cerebral abscess; and encephalitis. Three scans were false-positive; 12 patients with tumors had normal scans. Scans were graded according to the extent they changed the a priori diagnosis. They were found most useful in patients suspected of having posterior fossa disease, raised intracranial pressure, generalized encephalopathy or metastases, and after trauma, and least useful in cases of generalized seizures and mental or behavioral abnormalities.
Clearance of the Janus kinase 2 (<i>JAK2</i>) V617F mutation after allogeneic stem cell transplantation in a patient with myelofibrosis with myeloid metaplasia
Authors: Guillermo J. Ruiz‐Argüelles, Javier Garcés‐Eisele, Virginia Reyes‐Núñez, Guillermo J. Ruiz‐Delgado, Carlos Rosillo, John K. Camoriano
Journal: American Journal of Hematology (2006)

Abstract A patient with myelofibrosis with myeloid metaplasia displaying the V617F mutation of the JAK2 gene was given an allogeneic stem cell transplantation using a reduced‐intensity conditioning regimen. The patient engrafted, and as he became a chimera, the expression of the V617F mutation of the JAK2 gene decreased progressively until its disappearance. Accordingly, the concept of “molecular remission” of the myelofibrosis with myeloid metaplasia could be entertained and added to the categories of response to treatment which have been recently described. Am. J. Hematol., 2007. © 2006 Wiley‐Liss, Inc.
Dysphagia From Thoracic Ankylotic Spur
Authors: Michael R. Rask
Journal: JAMA (1978)

To the Editor.—  I have seen a patient with dysphagia from an ankylotic thoracic spur. The esophagus was impinged between the spur and the heart.  Report of a Case.—  An 80-year-old man has been careful about his health all his life and had been known to have ankylosing spondylitis since he was much younger. He exercises daily and takes vitamins. About three months previously he noted that one of his large vitamin capsules became lodged in his esophagus; it took a long time for the capsule to pass into his stomach. The vitamin became progressively harder to swallow. A barium swallow showed impingement of the esophagus between a huge ankylotic spur at D8-9 and the right atrium of the heart (Figure). The patient also has ankylosis in the cervical spine and matches the HLAB27 histocompatibility antigen. The patient does not wish osteophytectomy.
Prostatectomy v radiotherapy: possible detrimental effect of hormonal manipulation in patients receiving radiotherapy
Authors: C. G. Eden
Journal: BMJ (2014)

Evidence that surgery is more effective than radiotherapy at prolonging life in men with prostate cancer has been growing since the 1997 seminal study of 59 876 men,1 through two studies of 471 691,2 3 to Sooriakumaran and colleagues’ current paper, …
IL10 Released by a New Inflammation-regulated Lentiviral System Efficiently Attenuates Zymosan-induced Arthritis
Authors: Guillermo Garaulet, Arántzazu Alfranca, María Torrente, Amelia Escolano, Raquel López-Fontal, Sonsoles Hortelano, Juan M Redondo, Antonio Rodríguez
Journal: Molecular Therapy (2012)

Administration of anti-inflammatory cytokines is a common therapeutic strategy in chronic inflammatory diseases. Gene therapy is an efficient method for delivering therapeutic molecules to target cells. Expression of the cell adhesion molecule E-selectin (ESEL), which is expressed in the early stages of inflammation, is controlled by proinflammatory cytokines, making its promoter a good candidate for the design of inflammation-regulated gene therapy vectors. This study describes an ESEL promoter (ESELp)-based lentiviral vector (LV) that drives localized transgene expression during inflammation. Mouse matrigel plug assays with ESELp-transduced endothelial cells showed that systemic lipopolysaccharide (LPS) administration selectively induces ESELp-controlled luciferase expression in vivo. Inflammation-specific induction was confirmed in a mouse model of arthritis, showing that this LV is repeatedly induced early in acute inflammation episodes and is downregulated during remission. Moreover, the local acute inflammatory response in this animal model was efficiently blocked by expression of the anti-inflammatory cytokine interleukin-10 (IL10) driven by our LV system. This inflammation-regulated expression system has potential application in the design of new strategies for the local treatment of chronic inflammatory diseases such as cardiovascular and autoimmune diseases.
A Comparison of Cost Effectiveness Using Data from Randomized Trials or Actual Clinical Practice: Selective Cox-2 Inhibitors as an Example
Authors: Tjeerd-Pieter van Staa, Hubert G. Leufkens, Bill Zhang, Liam Smeeth
Journal: PLoS Medicine (2009)

Tjeerd-Pieter van Staa and colleagues estimate the likely cost effectiveness of selective Cox-2 inhibitors prescribed during routine clinical practice, as compared to the cost effectiveness predicted from randomized controlled trial data.
BUPA moves towards managed care
Authors: A. Ferriman
Journal: BMJ (1999)

Britain's largest private health insurer, BUPA, took a major step towards adopting the principles of American-style managed care when it announced this week that surgeons will have to obtain prior approval before performing hysterectomies.

Dr Andrew Vallance-Owen, BUPA's group medical director, said that, after extensive consultations with the profession, BUPA had drawn up evidence based guidelines on when a …
Review of publication bias in studies on publication bias: Here's a proposal for editors that may help reduce publication bias
Authors: M Maria Glymour, Ichiro Kawachi
Journal: BMJ (2005)

Childhood cancer and power linesWhat do the data mean?Editor-Draper et al used distance of mother's home from high voltage overhead transmission lines (predominantly 275 kV and 400 kV) at the time of her child's birth as a proxy for her child's subsequent exposure to power-frequency magnetic fields (reviewed by Ahlbom et al). 1 2 As they acknowledge, this is a crude estimate since, in contrast to other reports, 2 no household measurements were taken, no data on more prevalent low voltage distribution sources were collected, no information from other time points in the child's life was obtained, variations during the 33 years period studied were not considered, and no validatory home visits were carried out.A recent report into residential exposures to magnetic fields in the United Kingdom estimated that proximity to high voltage lines, 275 kV and above, explained only 9% of those with measurements ≥ 0.2 microtesla ( T). 3 National data on the distribution of houses in relation to high voltage lines in the UK were provided (J Swanson, National Grid Transco, personal communication, 2000) to the UK Childhood Cancer Study (UKCCS) Group for its study of power lines and childhood cancer, to assess the representativeness of study subjects. 4 An equivalent comparison using National Grid data spanning the far longer period investigated in the paper by Draper et al was not undertaken.The assessments of distance to power lines in the UKCCS were made for all registered controls, who have been shown to represent the general population. 5plot of the distributions of the leukaemia and non-leukaemia cases and controls in the study by Draper et al, national populations, and UKCCS populations by distance from high voltage lines (figure) seems to show that the leukaemia controls used in the analysis presented by Draper et al are systematically different.Their positive result over 100 m may therefore be explained not by an excess of cases but by a deficit of controls in the early years of the study.
BCL-2 rearranged B cell clones in chronic HCV infection: a possibile factor negatively influencing the virological response to treatment
Authors: Francesca Giannelli, Monica Monti, Patrizio Caini, Stefania Moscarella, Roberto Romanelli, Carlo Giannini, Laura Gragnani, Giorgio La Villa, Giacomo Laffi, Paolo Gentilini, Anna Linda Zignego
Journal: Journal of Hepatology (2002)
Editorial sparks debate over when Canadian parents should be told the sex of an unborn child
Authors: B. Kermode-Scott
Journal: BMJ (2012)

An editorial published in the journal of the Canadian Medical Association on 16 January entitled “‘It’s a girl!’—could be a death sentence” has sparked debate in Canada about when it is appropriate to reveal the sex of an unborn child to prospective parents.

In the editorial ( CMAJ , doi:10.1503/cmaj.120021) the journal’s interim editor in chief, Rajendra Kale, suggests that disclosure of the sex of an unborn child should be withheld until late pregnancy to prevent selective abortion of female fetuses. 

Dr Kale explains that he believes female feticide in Canada to …
Defective yeast opsonisation of serum in sarcoidosis.
Authors: N M Johnson, M W McNicol, A Kapoor, J E Burton-Kee, J F Mowbray
Journal: Thorax (1980)

We have studied the opsonising ability of the sera of 49 patients with sarcoidosis. The serum of 11 (22%) patients was defective in this ability, whereas only two (4%) of 46 clinic control subjects and three (7%) of 43 laboratory control subjects showed this defect. The difference between the prevalence of the defect in sarcoidosis and the control groups was statistically significant (p less than 0.01). Although the patients with sarcoidosis who had this defect tended to have pulmonary infiltration, this relationship was not statistically significant. Similarly, there was no correlation between the activity of sarcoidosis and this defect, although there was a significant (p less than 0.05) relationship between the opsonising defect and the persistence of circulating immune complexes. Serum opsonisation is a genetically linked host defense mechanism. Our findings suggest that the presence of this serum defect may render a person more susceptible to sarcoidosis.
A 39-Year-Old Man With HIV-Associated Lipodystrophy
Authors: Jon Fuller
Journal: JAMA (2008)

Human immunodeficiency virus (HIV)-associated lipodystrophy refers to fat accumulation, also known as lipohypertrophy, and fat wasting, also known as lipoatrophy. Both conditions can be very disturbing to patients and have been associated with metabolic disturbances such as insulin resistance and hyperlipidemias. The prevalence of HIV-associated lipodystrophy ranges from 6% to 69% in the medical literature. Although no clear associations have been made between specific drugs and HIV lipohypertrophy, stavudine and zidovudine have been implicated in the development of HIV lipoatrophy. The case of Mr B, a 39-year-old man with HIV-associated lipodystrophy whose facial changes are a cause of significant distress, highlights the need for clinicians to be attuned to the psychological impact that lipodystrophy can have on patients, especially because it may serve as a disincentive to adherence to antiretroviral drug regimens, resulting in an increased risk of developing viral resistance.
All-or-None Measurement of Health Care Quality—Reply
Authors: Thomas W. Nolan, Donald M. Berwick
Journal: JAMA (2006)

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THE ACTIVE AGENT IN MILK INJECTIONS
Authors: OTTO BARKAN
Journal: JAMA (1924)

The successful use of foreign protein injections for ocular disease dates from 1915, when it occurred to Schmidt<sup>1</sup>of Prague to use cow's milk for these injections. He chose milk because it was easy to procure and because the chemical composition of this animal secretion is a constant, whereas the composition of artificial preparations of proteins and their derivatives is subject to considerable variation. Since Schmidt's first report on the use of milk injections in ocular, as well as in general, disease, milk has been used in many thousands of cases by ophthalmologists, often with striking benefit. The literature is full of reports of good clinical results, and from personal experience we can heartily endorse the use of milk in certain kinds of ocular disease. There is no doubt of its efficacy in iritis, iridocyclitis and gonorrheal conjunctivitis, and as a prophylactic in infections of the eyeball following perforating