tbuckley/cabot-search huggingface dataset:
NHS is urged to implement guidelines to improve care of older people with diabetes
Authors: I. Torjesen
Journal: BMJ (2013)

Older people with diabetes are missing out on the essential care and aggressive treatment that can stop them developing complications, the Institute of Diabetes for Older People has warned.

The institute held a conference on 5 March to promote use of guidelines on type 2 diabetes in older people, developed by the European Diabetes Working Party for Older People.1 It launched a document outlining the particular problems faced by older people with diabetes and how doctors, nurses, and care home managers could deal with such problems.2

The prevalence of diabetes in people aged over 60 years is nearly seven times that in the 20-39 age group, it said. Over half (54%) of the 3.8 million people with diabetes in the United Kingdom are aged 60 years or over, and this proportion will …
Mutations in the basic core promotor and the precore region of hepatitis b virus and their selection in children with fulminant and chronic hepatitis B
Authors: Michael Friedt, Patrick Gerner, Ekkehart Lausch, Hubert Trübel, Bernhard Zabel, Stefan Wirth
Journal: Hepatology (1999)

The involvement of precore stop codon 1896–A and base exchanges in the AT–rich region at positions 1762 and 1764 of the hepatitis B core promotor has been controversely discussed in adults with fulminant hepatitis B. Because no data are currently available on children, we analyzed the basic core promotor (BCP) and precore region in children with chronic and fulminant hepatitis B. The BCP and precore region were sequenced directly and after cloning from mothers and infants. Thirteen children suffered from chronic liver disease, 6 of whom were treated with interferon alfa (IFN–α). All 13 patients seroconverted from hepatitis B e antigen (HBeAg) to hepatitis B e antigen antibodies (anti–HBe), and sera were analyzed before and after seroconversion. Nine vertically infected infants developed a fulminant course of hepatitis B. The occurrence of BCP (1762–T/1764–A, 7.7%) and precore (1896–A, 7.7%; 1899–A, 15%) mutations in chronic hepatitis B was rare. A genotype shift from D to A was observed in 3 patients after development of anti–HBe. A high number of base exchanges was detected in those infants with fulminant hepatitis B. Eight of nine showed a G–A exchange at positions 1896/97 (89%), 1899 (56%), and/or mutations at nucleotide (nt) positions 1762 (56%) and 1764 (78%). All virus strains belonged to genotype D, whereas in the only surviving infant, a D–to–A shift was detected. Hepatitis B virus (HBV) DNA clones were examined from 3 babies and 5 mothers. Our results showed a heterogeneous virus population in 4 of 5 mothers. In contrast, a homogeneous virus population emerged in the infants. According to our data, the analysis in children with fulminant and chronic hepatitis B revealed a striking presence of BCP and precore mutants in infants with fulminant hepatitis (FH) when compared with clinically inapparent anti–HBe-positive children ( P &lt; .002), which could be one factor in the pathogenesis of fulminant hepatitis B in children
Pemphigus foliaceus autoantibodies bind both epidermis and squamous mucosal epithelium, but tissue injury is detected only in the epidermis
Authors: Evandro A. Rivitti, José A. Sanches, Lucy M. Miyauchi, Sebastiao A.P. Sampaio, Valeria Aoki, Luis A. Diaz
Journal: Journal of the American Academy of Dermatology (1994)
Is Off-Pump CABG Really Inferior to On-Pump Strategies for Long-Term Survival?
Authors: Kan Kajimoto, Taira Yamamoto, Atsushi Amano
Journal: Journal of the American College of Cardiology (2014)

We read with interest the report by Kim et al. [(1)][1] indicating that post-operative survival was lower in patients who underwent off-pump coronary artery bypass grafting (CABG) than on-pump CABG. However, several crucial limitations to the study are notable and cast doubt on their conclusion
Renal parenchymal tumors and lymphoma in the same patient: Case series and review of the literature
Authors: Anuradha Kunthur, Peter H. Wiernik, Janice P. Dutcher
Journal: American Journal of Hematology (2006)

We reviewed the incidence of diagnosis of renal cell carcinoma and lymphoma in the same patient and analyzed the characteristics of this association. Nine patients in 4 years had the diagnosis of renal cell carcinoma (RCC) and lymphoma, including 2 with Hodgkin disease, 1 with chronic lymphocytic leukemia (CLL), and 3 each with low-grade follicular and intermediate-grade non-Hodgkin lymphoma (NHL). In SEER data, the observed/expected (O/E) ratio of NHL and RCC is 1.86 to 2.07. In our series, 2 patients were diagnosed with NHL after the diagnosis of RCC, 1 was diagnosed concurrently, and in the other 6, lymphoma preceded diagnosis of RCC. In reviews of second malignancies following treatment of Hodgkin disease, RCC is less common (O/E 1.5, with 1/3 being transitional cell carcinoma and 2/3 being adenocarcinoma). We report 2 cases with Hodgkin disease preceding RCC, and in both, Hodgkin disease occurred as an adult. There is a male predominance for patients with both diagnoses, which is greater than the male predominance for either RCC or NHL alone (2.2 vs. 2.0 vs. 1.2). There is an increased likelihood of the lymphoma being extranodal. There is an increased association of RCC and NHL more often among male patients, and often with extranodal lymphoma. Potential common etiological factors include prior treatment for malignancy, genetic predisposition, environmental factors, including a search for viral sequences, and possible immune dysregulation generating the lymphoma and subsequently leading to solid tumors such as RCC or melanoma.
Can St John's wort (hypericin) ingestion enhance the erythemal response during high-dose ultraviolet A1 therapy?
Authors: P.E. Beattie, R.S. Dawe, N.J. Traynor, J.A. Woods, J. Ferguson, S.H. Ibbotson
Journal: British Journal of Dermatology (2005)

St John's wort (SJW) is widely used as a treatment for depression. A phototoxic reaction, due to its content of hypericin, can occur in animals and in cell culture, and has been reported in humans. Hypericin displays absorption within the ultraviolet (UV) A1 spectrum and there may therefore be a potential for phototoxicity if taken during high-dose UVA1 therapy.To assess the phototoxicity risk of SJW ingestion.Eleven adult volunteers of skin types I and II were exposed to a geometric dose series of UVA1 irradiation from a high-output source (Dermalight Ultra 1; Dr Hönle, Martinsreid, Germany; irradiance 70-77 mW cm(-2)) on the photoprotected lower back skin at eight 1.5-cm(2) test areas. Irradiation was carried out at baseline and after 10 days of SJW extract 1020 mg (equivalent to 3000 microg of hypericin) daily. Four, 8, 24 and 48 h after each exposure, the minimal erythema dose (MED) and the presence or absence of pigmentation were recorded visually and erythema was assessed objectively with an erythema meter.The median MED and D(0.025), an objective measure of MED, were lower at all time-points after SJW ingestion. The visual erythemal peak (lowest median MED), which was seen at 8 h postirradiation, was lower after SJW (median 14 J cm(-2), range 10-56) than at baseline (median 20 J cm(-2), range 14-56) (P = 0.047). Similarly, the median D(0.025) at 8 h postirradiation was lower after SJW (median 22.0 J cm(-2), range 15.2-53.9) than at baseline (median 33.7 J cm(-2), range 22.9-136.0) (P = 0.014). The MED and D(0.025) were also significantly different at the 48-h and 4-h time-points, respectively. Significance was not reached at the 24-h time-point. Median intensity of postirradiation erythema increased at all time-points after ingestion of SJW. Despite these differences, the maximum slope of the dose-response curve was not increased after SJW ingestion.These data suggest that SJW extract has the potential to lower the erythemal threshold to UVA1 irradiation in a significant proportion of individuals and highlight the importance of ascertaining a full drug history, including herbal remedies, before initiating UVA1 phototherapy.
The Seemingly Ubiquitous Depression Following Acute Schizophrenic Episodes, A Neglected Area of Clinical Discussion
Authors: SHELDON ROTH
Journal: American Journal of Psychiatry (1970)

When the treatment of an acute schizophrenic episode is considered, prime emphasis is usually placed on the acute psychotic state as the major occurrence. The author stresses the need to focus also on what he calls the "compensated-transition" phase and the "depressive-neurasthenic" phase, which follow. The importance of treating these latter phases effectively, preferably by the same physician who treated the acute stage, should be given more attention in residency training programs, he believes.
Could NICE guidance on the choice of blood pressure lowering drugs be simplified?
Authors: R. Sofat, J. P. Casas, A. M. Grosso, B. N. C. Prichard, L. Smeeth, R. MacAllister, A. D. Hingorani
Journal: BMJ (2012)

Reecha Sofat and colleagues argue that prescribing advice needs updating in the light of recent evidence that all classes of blood pressure lowering drugs are broadly equivalent
Reviews, Notes, and Listings: Bargaining for Life: A Social History of Tuberculosis, 1876-1938
Authors: Robert Kaiser
Journal: Annals of Internal Medicine (1993)

Literature of Medicine1 June 1993Reviews, Notes, and Listings: Bargaining for Life: A Social History of Tuberculosis, 1876-1938Robert Kaiser, MDRobert Kaiser, MDUniversity of Pennsylvania School of Medicine, Philadelphia, PA 19106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-11-199306010-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Bargaining for Life: A Social History of Tuberculosis, 1876-1938Barbara Bates. 435 pages. Philadelphia: University of Pennsylvania Press; 1992. $19.95 (paper), $45.95 (cloth).Dr. Barbara Bates is probably best known to health professionals as the author of a best-selling textbook on physical examination. What they may not know, and will shortly discover, is that she is also a talented historian. This richly textured, beautifully written history examines tuberculosis in Pennsylvania over a period of seven decades. Bates has expertly used a unique and untouched source, the letters and papers of Dr. Lawrence Flick, a Philadelphia physician whose career spanned the ... Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania School of Medicine, Philadelphia, PA 19106. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1993Volume 118, Issue 11Page: 911KeywordsDietExerciseRacial and ethnic issues ePublished: 15 August 2000 Issue Published: 1 June 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Book: The Devil's Gardens: A History of Landmines
Authors: J. Pearn
Journal: BMJ (2002)

Lydia Monin, Andrew Gallimore Pimlico, £12.50, pp 234 ISBN 0 7126 6859 4 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> Doctors have international obligations in a contracting world; and many doctors today travel or work in one of the 28 or more countries where landmines are seeded. Knowledge about the threat of landmines and an understanding of the 2000 to 3000 blasts that occur each month—leaving a quarter of the victims dead … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Liquoid in Blood Cultures
Authors: E.G.L. WILKINS
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 June 1987Liquoid in Blood CulturesE.G.L. WILKINSE.G.L. WILKINSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-6-912_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the article by Aronson and Bor (1) on the performance of the blood culture as a diagnostic test, emphasis is placed on the importance of culturing at least 10 mL of blood for optimal isolation of organisms. Previous reports comparing 5 mL with 2 mL, 10 mL and 15 mL with 5 mL, and most recently 30 mL with 15 mL, have all shown a greater yield of positive isolates when larger volumes of blood are cultured (2). The authors also correctly state that the optimal blood-to-broth ratio is between 1:5 and 1:10 when liquoid (sodium...References1. ARONSONBOR MD. Blood cultures. Ann Intern Med. 1987;106:246-53. LinkGoogle Scholar2. SHANSONTHOMASWILSON DFD. Effect of volume of blood cultured on detection of Streptococcus viridans bacteraemia. J Clin Pathol. 1984;37:568-70. CrossrefMedlineGoogle Scholar3. AUCKENTHALERILSTRUPWASHINGTON RDJ. Comparison of recovery of organisms from blood cultures diluted 10% (volume/volume) and 20% (volume/volume). J Clin Microbiol. 1982;15:860-4. CrossrefMedlineGoogle Scholar4. SHANSON D. An experimental assessment of different anaerobic blood culture methods. J Clin Pathol. 1974;27:273-9. CrossrefMedlineGoogle Scholar5. GOULDDUERDEN JB. Blood culture—current state and future prospects. J Clin Pathol. 1983;36:967-77. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Mary's General Hospital Portsmouth PO3 GAQ England PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1987Volume 106, Issue 6Page: 912-912KeywordsBlood volumeHematologic testsSodium Issue Published: 1 June 1987 PDF downloadLoading ...
Vasoconstriction of canine coronary collateral vessels with vasopressin limits blood flow to collateral-dependent myocardium during exercise.
Authors: B W Foreman, X Z Dai, R J Bache
Journal: Circulation Research (1991)

This study was performed to test the hypothesis that active constriction of coronary collateral vessels can worsen hypoperfusion of collateral-dependent myocardium during exercise. Studies were performed in seven adult mongrel dogs in which intermittent followed by permanent occlusion of the left circumflex coronary artery produced an area of collateral-dependent myocardium without gross evidence of infarct. Myocardial blood flow was determined with microspheres while measurement of aortic and distal coronary pressures allowed calculation of collateral and small vessel resistance at rest and during treadmill exercise. The ability of collateral vessel constriction to limit blood flow was assessed by infusion of vasopressin during exercise. During control conditions, blood flow in the collateral zone underwent a subnormal increase during exercise in comparison with the normal zone (1.74 +/- 0.27 versus 2.50 +/- 0.40 ml/min/g, respectively, p less than 0.05). Infusion of vasopressin in a dose that caused no change in normal zone flow (0.01 microgram/kg/min i.v.) produced a 30 +/- 5% further decrease in flow to the collateral zone (p less than 0.01). This decrease in collateral zone flow resulted from a 48 +/- 14% increase in transcollateral resistance in response to vasopressin infusion (p less than 0.01), as well as a 40 +/- 9% increase in small vessel resistance in the collateral zone (p less than 0.01). These data demonstrate that active constriction of both collateral vessels and coronary resistance vessels can contribute to hypoperfusion of collateral-dependent myocardium during exercise.
Peripheral Circulatory Changes as Criteria for Hemorrhagic Shock Therapy
Authors: B. W. ZWEIFACH
Journal: Circulation (1950)

This study of hemorrhagic shock syndrome in dogs evaluates commonly used therapeutic procedures on the basis of ability to correct specific vascular decompensatory episodes associated with progressive refractoriness to blood transfusion. Using specific criteria (vasomotion, responsiveness to vasoconstrictor stimuli, tone of arterioles and venules and capillary blood flow), it was found that pressor drugs improved blood pressure only at the expense of peripheral circulation. However, drugs such as angiotonin and especially pitressin, when added to the transfusion medium in subpressor concentrations sufficient to produce only a tonic narrowing of the terminal arterioles, brought sustained improvement in blood flow through the omental vessels. That the prognosis for successful treatment of the circulatory collapse closely parallels the sequential changes which occur in the terminal vascular bed, adds further significance to the probable causal relationship between the observed vascular derangements and the ultimate collapse of the peripheral circulation.
Dartmouth Atlas of Health Care
Authors: R. Smith
Journal: BMJ (2011)

It is not wholly fanciful to compare the Dartmouth Atlas of Health Care with On the Origin of Species . Both books resulted from a rigorous accumulation of data and fundamentally changed our world view. Darwin’s book showed our descent from apes. The atlas exploded the belief that medicine is based firmly on science.

The first Dartmouth Atlas was published in 1996, and it is now a rich website with well presented maps and publications on healthcare in the United States. “Jack” Wennberg (as he is known) is the main author but was not the first to identify variations. The atlas pays tribute to the British paediatrician J Alison Glover, who observed in the 1930s that …
Effect of the geometry of the left ventricle on the calculation of ejection fraction.
Authors: J G Dumesnil, R M Shoucri
Journal: Circulation (1982)

We used a cylindrical model for the left ventricle contracting both radially and longitudinally to show how the ejection fraction is related to different variables that describe the ventricular geometry. The relations during ventricular contraction between wall thickening, midwall radius shortening and longitudinal shortening are used to derive precise formulas for the calculation of ventricular blood flow velocity and ejection fraction. Validation of the model is given by results from the literature and by a study of 40 patients. The formulas derived can be used to validate angiographic measurements or to assess more precisely blood flow velocity and ejection fraction from the M-mode echocardiogram. Ejection fraction is determined not only by the extent of myocardial shortening, but also by the relationship of ventricular wall thickness to ventricular cavity size.
Interleukin-15-Dependent NKp46+ Innate Lymphoid Cells Control Intestinal Inflammation by Recruiting Inflammatory Monocytes
Authors: Julie Schulthess, Bertrand Meresse, Emma Ramiro-Puig, Nicolas Montcuquet, Sylvie Darche, Bernadette Bègue, Frank Ruemmele, Christophe Combadière, James P. Di Santo, Dominique Buzoni-Gatel, Nadine Cerf-Bensussan
Journal: Immunity (2012)
Snoring as a risk factor for disease: an epidemiological survey.
Authors: P G Norton, E V Dunn
Journal: BMJ (1985)

In a study conducted in four family practice units in Toronto, Canada, 2001 subjects reported on snoring and medical conditions in members of their households. For spouses the prevalence of snoring increased with age up to the seventh decade, with a higher prevalence of nearly 85% in husbands. For 11 medical problems an association existed between snoring, its frequency, and the presence of the condition. This association continued when the data were corrected for sex, age, and marital state. For hypertension both men and women who snored between the fifth and 10th decades had a twofold increase over non-snorers. The prevalence of heart disease and other conditions, except for diabetes and asthma, also increased in snorers in this age group. When corrected for smoking and obesity the association between snoring, hypertension, and heart disease persisted. These findings extend those of Lugaresi et al, and if they could be confirmed snoring as a risk factor for conditions other than sleep apnoea and sleep disorders might be considered. Methods of alleviating the acoustic annoyance of snoring may also provide direct medical benefits.
Hospitals forecast a rise in emergency admissions, while commissioners forecast a fall
Authors: M. Limb
Journal: BMJ (2014)

Cracks in NHS performance in England are appearing alongside signs of a “worrying mismatch” in planning between those who commission and those who provide services, an analysis shows.

The health think tank the King’s Fund has said that growing pressure on finance and rising demand for services meant that hospitals had to choose between maintaining the quality of care and balancing the books. Many hospital trusts were recruiting more nurses, despite budgets being stretched to the limit: the nursing workforce rose by almost 9000 over the past six months to nearly 315 000, the “highest on record,” the fund said.

The fund published its latest quarterly monitoring report, for the period from April to June 2014, on Thursday 17 July.1

It also reported that a quarter of NHS trust finance directors (18 of 73 surveyed) said that they expected to overspend their budgets in 2014-15. …
Determinants of the Left Atrial Pressure Pulse in Mitral Valve Disease
Authors: NEIL A. J. HAMER, SUJOY B. ROY, JAMES W. DOW
Journal: Circulation (1959)

The difficulties of preoperative evaluation of patients with combinations of mitral stenosis and incompetence prompted analysis of the left atrial pressure pulse in a series of patients studied by left atrial puncture. Theoretic considerations indicate that similar pressure pulses may be produced by a variety of mitral valve lesions if the volume-pressure characteristics of the left atrium are appropriate. An explanation is offered for the differences found in the presence of mitral regurgitation.
How neuroscience accounts for the illusion of conscious will
Authors: Masao Ito
Journal: Behavioral and Brain Sciences (2004)

Wegner's monograph presents the view that conscious will is a feeling that we experience when we perform an action through a mechanistic process of the brain, rather than a mental force that causes the action. The view is supported by several lines of evidence in which conscious will is dissociated from the actual performance of voluntary movements, as in automatism. The book further extends an insightful analysis of the mental system behind the illusion of conscious will and inspires neuroscientists to reflect on its neural substrates.
Specific Laboratory Test for Diagnosis of Multiple Sclerosis
Authors: E. J. Field, B. K. Shenton, G. Joyce
Journal: BMJ (1974)

Lymphocytes from patients with multiple sclerosis are much more susceptible to the inhibitory activity of linoleic acid (0.08 mg/ml) when tested for sensitization to thyroid by the macrophage electrophoretic mobility test (91% inhibition) than are those from normal subjects (57% inhibition). Cells from patients with a variety of other neurological diseases give 47% inhibition with linoleic acid. These differences are specific for multiple sclerosis and can be used as an in-vitro diagnostic test for the disease. Nearly 43% of clinically normal near relatives of patients with multiple sclerosis show an "anomalous" figure of about 77%; in the remainder the figure is the same as in the general population (57%). An anomalous result is compatible with lifelong freedom from M.S. Possibly a congenital anomalous handling of unsaturated fatty acids is a constant feature of the disease.