tbuckley/cabot-search huggingface dataset:
Training and careers in France
Authors: Herv Maisonneuve, Yves Matillon
Journal: BMJ (2007)

The United Kingdom is not alone in its uncertainty about doctors' training and careers.1 Other European countries, and particularly France, are struggling with a shortage of junior doctors and an uneven distribution of doctors across the country, leading to potential issues regarding the immigration of doctors to fill the gaps.

In France, medical schools admitted 8000 students in 1975, 6000 …
Access to Palliative Care and Hospice in Nursing Homes
Authors: Judy Zerzan
Journal: JAMA (2000)

Nursing homes are the site of death for many elderly patients with incurable chronic illness, yet dying nursing home residents have limited access to palliative care and hospice. The probability that a nursing home will be the site of death increased from 18.7% in 1986 to 20.0% by 1993. Dying residents experience high rates of untreated pain and other symptoms. They and their family members are isolated from social and spiritual support. Hospice improves end-of-life care for dying nursing home residents by improving pain control, reducing hospitalization, and reducing use of tube feeding, but it is rarely used. For example, in 1997 only 13% of hospice enrollees were in nursing homes while 87% were in private homes, and 70% of nursing homes had no hospice patients. Hospice use varies by region, and rates of use are associated with nursing home administrators' attitudes toward hospice and contractual obligations. Current health policy discourages use of palliative care and hospice for dying nursing home residents. Quality standards and reimbursement rules provide incentives for restorative care and technologically intensive treatments rather than labor-intensive palliative care. Reimbursement incentives, contractual requirements, and concerns about health care fraud also limit its use. Changes in health policy, quality standards, and reimbursement incentives are essential to improve access to palliative care and hospice for dying nursing home residents. JAMA. 2000;284:2489-2494.
Management of Gout
Authors: PETER A. SIMKIN
Journal: Annals of Internal Medicine (1979)

The diagnosis of gout depends on showing urate crystals in synovial effusions or, with less certainty, recognizing a characteristic clinical presentation. The management of gout has four phases: control of inflammation, diagnostic evaluation, education of the patient, and treatment for the hyperuricemia. Sound logical principles guide each aspect. Careful attention to these four phases of management should lead to highly satisfactory control of the syndrome of gout.
Oxidative stress contributes to the reduced tolerance of fatty livers to reperfusion injury
Authors: P. Caraceni, M. Domenicali, I. Grattagliano, AM. Morselli-Labate, B. Nardo, M. Simoncini, F. Trevisani, E. Altomare, A. Cavallari, M. Bernardi
Journal: Journal of Hepatology (1998)
Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity
Authors: Paul M. Coen, Charles J. Tanner, Nicole L. Helbling, Gabriel S. Dubis, Kazanna C. Hames, Hui Xie, George M. Eid, Maja Stefanovic-Racic, Frederico G.S. Toledo, John M. Jakicic, Joseph A. Houmard, Bret H. Goodpaster
Journal: Journal of Clinical Investigation (2014)

BACKGROUND. Roux-en-Y gastric bypass (RYGB) surgery causes profound weight loss and improves insulin sensitivity (SI) in obese patients. Regular exercise can also improve SI in obese individuals; however, it is unknown whether exercise and RYGB surgery–induced weight loss would additively improve SI and other cardiometabolic factors.
Characterization of a late transitional B cell population highly sensitive to BAFF-mediated homeostatic proliferation
Authors: Almut Meyer-Bahlburg, Sarah F. Andrews, Karl O.A. Yu, Steven A. Porcelli, David J. Rawlings
Journal: The Journal of Experimental Medicine (2008)

We have characterized a distinct, late transitional B cell subset, CD21int transitional 2 (T2) B cells. In contrast to early transitional B cells, CD21int T2 B cells exhibit augmented responses to a range of potential microenvironmental stimuli. Adoptive transfer studies demonstrate that this subset is an immediate precursor of both follicular mature and marginal zone (MZ) B cells. In vivo, a large percentage of CD21int T2 B cells has entered the cell cycle, and the cycling subpopulation exhibits further augmentation in mitogenic responses and B cell-activating factor of the TNF family (BAFF) receptor expression. Consistent with these features, CD21int T2 cells exhibit preferential responses to BAFF-facilitated homeostatic signals in vivo. In addition, we demonstrate that M167 B cell receptor (BCR) idiotypic-specific B cells are first selected within the cycling CD21int T2 population, ultimately leading to preferential enrichment of these cells within the MZ B cell compartment. These data, in association with the coordinate role for BAFF and microenvironmental cues in determining the mature BCR repertoire, imply that this subset functions as a unique selection point in peripheral B cell development.
On the Epidemiology of Hemophilia and Christmas Disease
Authors: Oscar D. Ratnoff, Alvin Margolius
Journal: New England Journal of Medicine (1957)

A FEW years ago, it became apparent that the symptom complex then called hemophilia could in fact be due to either of two readily separable genetic defects. The commoner disorder, classic hemophilia, is thought by most investigators to be associated with a deficiency in the plasma of antihemophilic factor. The second, rarer, disorder has been called Christmas disease; in this case the patient's plasma lacks Christmas factor, or plasma thromboplastin component. These two disorders seem inseparable clinically, and the pattern of inheritance is the same in both.The relative incidence of classic hemophilia and Christmas disease has been studied by . . .
Effect of nitrates on LOS pressure in achalasia: a potential therapeutic aid.
Authors: M Gelfond, P Rozen, S Keren, T Gilat
Journal: Gut (1981)

The effect of a long-acting nitrate, isosorbide dinitrate (ID) 5 mg sublingually, on the lower oesophageal sphincter was tested in 24 patients with achalasia. The drug caused a reduction in LOS pressure in all cases. The mean LOS pressure fell from 46.32.7 mmHg to 15.31.8 mmHg (p less than 0.01). The pressure began to drop after several minutes, reaching its lowest levels after 15 minutes. This measured manometric effect lasted for 60 minutes or more in 10 patients studied. The reported clinic effect lasted for two to three hours, permitting the ingestion of a meal. Twenty-three patients were followed clinically for two to 19 months while receiving the drug three times daily before meals. Nineteen reported a marked to complete relief of dysphagia. Five of these patients had previous pneumatic dilatation, cardiomyotomy, or both, and had recurrence at time of study. Side-effect, mainly headache, were reported in eight patients. In six this was alleviated by substituting oral isosorbide dinitrate, 10 mg. Two patients became refractory to treatment after two to six months. The potential role of long-acting nitrates in the treatment of achalasia has yet to be established.
EXCISION OF BARTHOLIN GLAND CYSTS
Authors: G. H. Taubles
Journal: JAMA (1927)

The technic described below is offered to simplify the excision of Bartholin gland cysts by keeping the form of the tumor intact until the dissection is complete. This will obviate the deep incision sometimes necessitated when the cyst contents escape before the operation is completed and will keep the rather copious bleeding to a minimum. With a syringe having a short 16 or 18 gage needle, the cyst contents are evacuated; the syringe is detached and the needle left in place. Then a second syringe filled with melted paraffin (melting point about 45 C.) is attached and enough paraffin injected to replace the fluid withdrawn. After the paraffin has hardened, the dissection will be found to be facilitated. A 10 or 20 cc. record syringe will hold enough heat to keep the paraffin fluid, and the syringe should be kept warm till needed. The addition of methylene blue or other
Idiopathic Thrombocytopenic Purpura in Patients With Histoplasmosis
Authors: James Olen Armitage, Raymond F. Sheets
Journal: JAMA (1977)

THROMBOCYTOPENIC purpura has been reported secondary to a multiplicity of causes.<sup>1</sup>However, idiopathic thrombocytopenic purpura (ITP), in relation to infectious diseases other than viral illnesses, is unusual. We report two cases where ITP developed with the onset of histoplasmosis. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 41-year-old woman was referred to the University of Iowa Hospitals on July 3, 1970, with a two-week history of fevers, chills, headache, nonproductive cough, and a 7-kg weight loss. She had failed to respond to oral antibiotic therapy. She had been in good health prior to the onset of the aforementioned symptoms, and there was no antecedent history of easy bleeding, bruising, or hematologic abnormality. The patient appeared severely ill and was febrile. Neither lymphadenopathy nor hepatosplenomegaly was found. Pulmonary and cardiovascular examination results were unremarkable. Petechiae and ecchymoses were not observed. Initial laboratory studies included a WBC count of 7,400/cu mm, with 81%
Phase I/II Study of Pemetrexed With or Without ABT-751 in Advanced or Metastatic Non–Small-Cell Lung Cancer
Authors: Charles M. Rudin, Ann Mauer, Martin Smakal, Rosalyn Juergens, Stanislav Spelda, Michael Wertheim, Andrew Coates, Evelyn McKeegan, Peter Ansell, Xiangdong Zhou, Jane Qian, Rajendra Pradhan, Barry Dowell, Andrew Krivoshik, Gary Gordon
Journal: Journal of Clinical Oncology (2011)

Purpose ABT-751 is an antimitotic and vascular disrupting agent with potent preclinical anticancer activity. We conducted a phase I and randomized double-blind phase II study of pemetrexed with ABT-751 or placebo in patients with recurrent advanced or metastatic non–small-cell lung cancer (NSCLC). Methods One hundred seventy-one patients received intravenous pemetrexed 500 mg/m 2 day 1 and oral ABT-751 or placebo days 1 to 14 of 21-day cycles. The primary end point was progression-free survival (PFS). Secondary end point included overall survival (OS); pharmacokinetic and pharmacodynamic parameters were also analyzed. Results The recommended phase II dose of ABT-751 with pemetrexed is 200 mg. Fatigue, constipation, anemia, nausea, and diarrhea were the most common toxicities in both study arms. No pharmacokinetic interactions were observed. Median PFS in the ABT-751 arm was 2.3 months versus 1.9 for placebo (P = .819, log-rank) for the intention-to-treat population. However, differences in PFS (P = .112, log-rank) and OS (P = .034, log-rank; median 3.3 v 8.1 months) favoring ABT-751 were seen in the squamous NSCLC subgroup. Baseline circulating tumor cell concentrations were predictive of improved OS (P = .013). Changes from baseline of greater than 20% in plasma levels of placenta growth factor (P = .056), squamous cell carcinoma antigen (P = .03), and cytokeratin 19 fragment antigen 21-1 (P = .01) were markers best associated with improved OS. Conclusion Addition of ABT-751 to pemetrexed is well-tolerated, but does not improve outcome in unselected patients with recurrent NSCLC. ABT-751 may have therapeutic potential in squamous NSCLC. Exploratory cellular and molecular analyses in this study identified biomarkers that may correlate with survival.
Pressure grows on government to act on obesity as figures show effect on health and the NHS
Authors: M. Limb
Journal: BMJ (2013)

The government is coming under increasing pressure to change its approach to tackling obesity, as figures show that hospital admissions for obesity are rising and that the general population is ignoring advice on healthy diet and exercise levels.

The number of inpatient admissions with a primary diagnosis of obesity reached 11 736 in 2011-12, according to a report from the Health and Social Care Information Centre (HSCIC), published on 20 February.1 This number is a 1% increase on admissions in the previous year (11 570 in 2010-11), triple the number five years ago (3860 in 2006-07), and 11 times the number 10 years ago (1019 in 2001-02). In 2011-12, female admissions for obesity were almost three times higher than male admissions (8740 v 2990).

The numbers of bariatric surgical procedures, including stomach stapling and gastric …
TCT-875 Frailty is a Major Determinant of Length of Stay After Transcatheter Aortic Valve Replacement
Authors: Abhijit Ghatak, Brian O'Neill, Ruchi Patel, Sachil Shah, Claudia Martinez, Mauro Moscucci, Pedro Clark, Mauricio Cohen, Alan Heldman, William O'Neill, Carlos Alfonso
Journal: Journal of the American College of Cardiology (2012)
Effects of non-shunting operation on azygos venous blood flow in cirrhotic patients.
Authors: N Kokudo, S Kawasaki, K Ohashi, H Sakamoto, H Koyama, K Sanjo, Y Idezuki
Journal: Gut (1989)

Azygos venous blood flow and other haemodynamic parameters were measured in 14 cirrhotic patients to investigate the effects of a non-shunting operation, oesophageal transection with paraoesophagogastric devascularisation. Azygos venous blood flow measured by the local continuous thermal dilution method was significantly reduced by 13.8% after the operation (428 (41) v 369 (33) ml/min). Hepatic venous pressure gradient (HVPG) was also significantly decreased from 14.5 (0.8) to 12.8 (0.7) mmHg (-11.8%). Cardiac output and routine liver tests did not change remarkably postoperatively. In this haemodynamic study before and after non-shunting operation, moderate but significant decreases were seen in azygos venous blood flow and portal pressure (HVPG), without substantial changes in systemic circulation. This suggests that blood flow through the portosystemic collaterals other than oesophageal varices may be decreased but still adequate after the operation. Well preserved portosystemic collaterals without oesophageal varices are thus considered an optimally balanced state after non-shunting operation.
Antiviral activity, safety, and pharmacokinetics of danoprevir/ritonavir plus PEG-IFN α-2a/RBV in hepatitis C patients
Authors: Edward J. Gane, Regine Rouzier, Catherine Stedman, Alicja Wiercinska-Drapalo, Andrzej Horban, Linda Chang, Ying Zhang, Pratibha Sampeur, Isabel Nájera, Patrick Smith, Nancy S. Shulman, Jonathan Q. Tran
Journal: Journal of Hepatology (2011)
The Role of Dragon (Repulsive Guidance Molecule-B, RGM-B) in Human Breast Cancer.
Authors: J. Li, L. Ye, A. Sanders, R. Mansel, W. Jiang
Journal: Cancer Research (2009)

Abstract Introduction: Repulsive guidance molecules (RGMs) are involved in embryonic development and iron homeostasis. RGM-A mediates repulsive axonal guidance and neural tube closure, and RGM-C is mutated in juvenile hemochromatosis. RGM-B, also known as Dragon, is a myelin-derived inhibitor of axon growth in the central nervous system. The RGM family was also identified as co-receptors of bone morphogenetic proteins (BMPs), a group of proteins that are involved in development of bones, the differentiation and progression of cancer. However, the role of RGMs played in breast cancer remains unclear. In the present study, we examined the pattern of expression of the RGM family in human breast cancer cells and investigated the impact of Dragon (RGM-B) on BMP-induced cell function in breast cancer cells.Material and Methods: Conventional RT-PCR was performed to screen the expression of RGMs in human breast cancer samples and a range of breast cancer cell lines. Dragon/RGM-B ribozyme transgenes were generated and in order to knock down the Dragon transcript. Subsequently, MDA-231RGMB-Knock-down variants were created by way of the transgenes. A series of cell function assays were employed to investigate any biological effects upon RGM-B knockdown on the breast cancer cells as well as cell's response to recombinant BMP proteins.Results: RGM-A and RGM-C transcripts were barely detectable in breast cancer cell lines (MDA-MB-231 and MCF-7) and tissues. However RGM-B transcripts were expressed in both cell lines. Using anti-RGM-B transgenes, MDA-231RGMB-Knock-down variant cell lines, in which RGM-B transcripts were knocked down, were created. Compared with wild type and control transfection, MDA-231RGMB-Knock-down variants displayed a significant increase in both the adhesiveness and cells growth (p &amp;lt; 0.05, vs the respective controls, for adheresion and for cell growth). Interestingly, RGM-B knockdown did not have any significant effects on the invasiveness of the cells. Finally, wild type breast cancer cells and the RGMB knock down variant cell lines showed a similar response to the treatment with rhBMP-11, indicating that RGM-B is less critical in BMP-11 mediated cell functions.Conclusion: The present study is the first to examine the role of RGM-B in breast cancer and has demonstrated that knock-down of RGMB could enhance breast cancer cells' ability to grow and attach, indicating that RGM-B may act as an inhibitor in breast cancer. This property is unique to RGMB, as this ability is not associated with any other member in the RGM family. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6158.
Reciprocal cellular cross-talk within the tumor microenvironment promotes oncolytic virus activity
Authors: Carolina S Ilkow, Monique Marguerie, Cory Batenchuk, Justin Mayer, Daniela Ben Neriah, Sophie Cousineau, Theresa Falls, Victoria A Jennings, Meaghan Boileau, David Bellamy, Donald Bastin, Christiano Tanese de Souza, Almohanad Alkayyal, Jiqing Zhang, Fabrice Le Boeuf, Rozanne Arulanandam, Lawton Stubbert, Padma Sampath, Steve H Thorne, Piriya Paramanthan, Avijit Chatterjee, Robert M Strieter, Marie Burdick, Christina L Addison, David F Stojdl, Harold L Atkins, Rebecca C Auer, Jean-Simon Diallo, Brian D Lichty, John C Bell
Journal: Nature Medicine (2015)
Informing Resource-Poor Populations and the Delivery of Entitled Health and Social Services in Rural India
Authors: Priyanka Pandey, Ashwini R. Sehgal, Michelle Riboud, David Levine, Madhav Goyal
Journal: JAMA (2007)

A lack of awareness about entitled health and social services may contribute to poor delivery of such services in developing countries, especially among individuals of low socioeconomic status.To determine the impact of informing resource-poor rural populations about entitled services.Community-based, cluster randomized controlled trial conducted from May 2004 to May 2005 in 105 randomly selected village clusters in Uttar Pradesh state in India. Households (548 intervention and 497 control) were selected by a systematic sampling design, including both low-caste and mid- to high-caste households.Four to 6 public meetings were held in each intervention village cluster to disseminate information on entitled health services, entitled education services, and village governance requirements. No intervention took place in control village clusters.Visits by nurse midwife; prenatal examinations, tetanus vaccinations, and prenatal supplements received by pregnant women; vaccinations received by infants; excess school fees charged; occurrence of village council meetings; and development work in villages.At baseline, there were no significant differences in self-reported delivery of health and social services. After 1 year, intervention villagers reported better delivery of several services compared with control villagers: in a multivariate analysis, 30% more prenatal examinations (95% confidence interval [CI], 17%-43%; P < .001), 27% more tetanus vaccinations (95% CI, 12%-41%; P < .001), 24% more prenatal supplements (95% CI, 8%-39%; P = .003), 25% more infant vaccinations (95% CI, 8%-42%; P = .004), and decreased excess school fees of 8 rupees (95% CI, 4-13 rupees; P < .001). In a difference-in-differences analysis, 21% more village council meetings were reported (95% CI, 5%-36%; P = .01). There were no improvements in visits by a nurse midwife or in development work in the villages. Both low-caste and mid- to high-caste intervention households reported significant improvements in service delivery.Informing resource-poor rural populations in India about entitled services enhanced the delivery of health and social services among both low- and mid- to high-caste households. Interventions that emphasize educating resource-poor populations about entitled services may improve the delivery of such services.clinicaltrials.gov Identifier: NCT00421291.
MORTALITY AND OUTCOMES OF PATIENTS PRESENTING WITH AND WITHOUT IATROGENIC AORTIC DISSECTIONS
Authors: Neil Parikh, Santi Trimarchi, Truls Myrmel, Daniel Montgomery, Matthias Voehringer, Reed Pyeritz, Thomas Tsai, Mark Russo, Giuseppe DiBenedetto, Andrea Ballotta, Nimesh D. Desai, Christoph Nienaber, Kim Eagle, Eric Isselbacher, Himanshu Patel
Journal: Journal of the American College of Cardiology (2012)
Walter H. Judd, MD
Authors: David Orentstein
Journal: JAMA (1994)

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Singing the royal blues
Authors: Theodore Dalrymple
Journal: BMJ (2008)

Friedrich Schiller (1759-1805) was the son of a doctor and a doctor himself, and yet when people compile lists of famous doctor-writers, strangely he is seldom included. I don’t really know why this should be. It is true that he was a somewhat reluctant member of our profession, and practised for only a short time as a regimental surgeon in Wurttemberg; but Somerset Maugham never practised once he had qualified, and he is always included in such lists.

One of Schiller’s best-known plays is Don Carlos , which combines romanticism with the ideals of the Enlightenment. It is so long that it has never been performed in its original version, concision not being Schiller’s virtue at the time. Set in the Spain of …