tbuckley/cabot-search huggingface dataset:
P227 Disparities in care of adult CF patients in the UK
Authors: M. Salako, S. J. MacNeill, E. Gunn, M. Baker, D. Bilton, P. Cullinan
Journal: Thorax (2010)

<h3>Background</h3> Studies in the late ‘80s and early ‘90s suggested that survival in UK CF patients was better in those from non-manual social classes and that adults attending specialist clinics (66% of the total) received more intensive care. Twenty years on, we assessed whether treatments and outcomes varied by specialist care and the socio-economic status (SES) of patients. <h3>Methods</h3> The CF Trust provided 2008 annual review data for patients attending UK adult clinics (n=3182). Three models of care were identified: “centre”, “shared” between specialist and non-specialist clinics and non-specialist “stand-alone”. SES was estimated by Townsend scores at CAS ward level. Distance to clinic was calculated as the distance between the patients’ home postcode and that of their clinic. <h3>Results</h3> In 2008 most patients received “centre care” (94%) and few received “stand-alone care” (4%). There were no differences in rates of dornase alfa, pancreatic enzyme or IV antibiotic treatment between models. The highest rates of chronic <i>Pseudomonas aeruginosa</i> (PA) infections were in patients attending “centre care” (“centre” 62%: “shared” 56%: “stand-alone” 49%; p=0.01) but there were no differences in FEV<sub>1</sub>%predicted. Most patients (91%) lived &lt;50 miles of their clinic; the distribution of clinics broadly reflected that of patients. Although those living near their clinic were less likely to be using dornase alfa (&lt;50 miles 43%: ≥50 miles 52%, p=0.003), there were no differences in chronic Pa infection or FEV<sub>1</sub>% predicted. There were more patients than expected in the least deprived quintile of SES (30%) and fewer in the most deprived (10%). There was a decreasing trend in dornase α treatment with increasing deprivation (least deprived 48%: 43%: 41%: 41%: most deprived 42%, p=0.004) although when stratified by disease severity this was only significant among patients with mild disease (70% ≤FEV<sub>1</sub>% predicted &lt;90%). There were no differences in chronic Pa infections or FEV<sub>1</sub>% predicted. <h3>Conclusion</h3> In the last 20 years, the proportion of adults attending specialist clinics has increased and the majority live near their clinics. Despite these improvements, there exist disparities in treatment by distance and SES and chronic Pa infections by model of care.
Adrenal Insufficiency due to Cryptococcosis
Authors: Bharat Shah
Journal: JAMA (1986)

UNTIL the mid-1930s, tuberculosis had traditionally been considered to be the most frequent cause of primary adrenal insufficiency. With a progressive decrease in the prevalence of this granulomatous process, however, autoimmune disease has superseded tuberculosis as the most frequent cause of primary adrenal insufficiency.<sup>1</sup>It is amply documented, nevertheless, that certain fungal diseases such as histoplasmosis as well as neoplasms may destroy sufficient adrenal tissue to produce the signs and symptoms of Addison's disease.<sup>2-4</sup>It is our purpose herein to point out the less well-known fact that other fungal diseases, by means of massive destruction of the adrenal glands, may likewise produce adrenal insufficiency. Specifically, we detail what to the best of our knowledge is the second reported, antemortem biochemically and histopathologically confirmed documentation of cryptococcal-induced adrenal cortical insufficiency. We likewise point out the value of computed tomographic (CT) scanning of the adrenal glands to assist in the
Nonmitogenic Anti-CD3 Monoclonal Antibodies Deliver a Partial T Cell Receptor Signal and Induce Clonal Anergy
Authors: Judith A. Smith, J. Yun Tso, Marcus R. Clark, Michael S. Cole, Jeffrey A. Bluestone
Journal: The Journal of Experimental Medicine (1997)

Anti-CD3 monoclonal antibodies (mAbs) are potent immunosuppressive agents used in clinical transplantation. However, the activation-related adverse side effects associated with these mAbs have prompted the development of less toxic nonmitogenic anti-CD3 mAb therapies. At present, the functional and biochemical consequences of T cell exposure to nonmitogenic anti-CD3 is unclear. In this study, we have examined the early signaling events triggered by a nonmitogenic anti-CD3 mAb. Like the mitogenic anti-CD3 mAb, nonmitogenic anti-CD3 triggered changes in the T cell receptor (TCR) complex, including ζ chain tyrosine phosphorylation and ZAP-70 association. However, unlike the mitogenic anti-CD3 stimulation, nonmitogenic anti-CD3 was ineffective at inducing the highly phosphorylated form of ζ (p23) and tyrosine phosphorylation of the associated ZAP-70 tyrosine kinase. This proximal signaling deficiency correlated with minimal phospholipase Cγ-1 phosphorylation and failure to mobilize detectable Ca2+. Not only did biochemical signals delivered by nonmitogenic anti-CD3 resemble altered peptide ligand signaling, but exposure of Th1 clones to nonmitogenic anti-CD3 also resulted in functional anergy. Finally, a bispecific anti-CD3 × anti-CD4 F(ab)′2 reconstituted early signal transduction events and induced proliferation, suggesting that defective association of lck with the TCR complex may underlie the observed signaling differences between the mitogenic and nonmitogenic anti-CD3.
Time course and intensity of anthralin inflammation on involved and uninvolved psoriatic skin
Authors: Y. PARAMSOTHY, C.M. LAWRENCE
Journal: British Journal of Dermatology (1987)

Journal Article Time course and intensity of anthralin inflammation on involved and uninvolved psoriatic skin Get access Y. PARAMSOTHY, Y. PARAMSOTHY Department of Dermatology, North Staffs. Hospital Centre, Stoke‐on‐Trent ST4 7PA, U.K. Search for other works by this author on: Oxford Academic Google Scholar C.M. LAWRENCE C.M. LAWRENCE Department of Dermatology, North Staffs. Hospital Centre, Stoke‐on‐Trent ST4 7PA, U.K. Dr C.M. Lawrence Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 116, Issue 4, 1 April 1987, Pages 517–519, https://doi.org/10.1111/j.1365-2133.1987.tb05871.x Published: 01 April 1987
Some Principles of Reform in Medical Education
Authors: F. M. R. Walshe
Journal: BMJ (1944)

he recasting of medical education, having been a topic of recurrent discussion for many years, begins to show signs of becoming a subject of action, and the two reports recently issued by committees of the Royal College of Physicians on social and on psychological medicine lay down lines of reform that seem expedient to some of our number.It is probably reasonable to assume that the two reports are but the heralds of comparable recommenda- tions in respect of other branches of medicine, andthere are signs that the specialists will shortly be on the march at the head of thousands of words, determined to bend the medical student to their will.The Need for RevisionF ew would deny that the methods and content of our present teaching call urgently for rev'ision, but if we were to ask at la'rge, "What are the important defects in the educational diet we provide for the medical s-tudent?"we should probably get as many and as diverse answers as there are special aspects of m-edicine, though we dare not be' so sanguine as to anticipate that many of these answers would be the fruit of general ideas on the subject, or that they would dive beneath the surface of -the obvious.symptoms in search of fundamental faults.We should probably be assured on almost all hands that the student must know more about most of the special branches, and must acquire familiarity with more, and more complex, techniques.That this is no wild surmise is plainly exemplified in the report on psychological medicine already referred to.This suggests a fully detailed syllabus comprised as follows:'During the Preclinical Years 12 to 20 lectures on normal psychology.Visits to schools, courts, and factories.During the Clinical Years 6 introductory lectures on clinical psychology and psychiatry.53 further lectures and demonstrations on specified aspects of the subject.Seminars and discussion groups covering, the whole field. Three months' clinicalclerking to an in-and out-patient psychiatric department of the hospital.short term of undergraduate residence in a mental hospital, or, alternatively, a clinical clerkship in a mental observation ward.series of domiciliary visits with a psychiatric social worker.
353. Biological Comparison of Mesenchymal Stem Cells Derived from Bone Marrow and Adipose Tissue
Authors: Reza Izadpanah, Cynthia Trygg, Christopher Kriedt, Bruce Bunnell
Journal: Molecular Therapy (2006)

The potential of adult mesenchymal stem cells (MSCs) to differentiate to diverse cell types in vitro and in vivo offers outstanding opportunities to use these cells as therapeutic agents. The biological characteristics of MSCs isolated from two distinct tissues, bone marrow and adipose tissue were evaluated in vitro and in vivo. MSCs derived from human and non-human primate (rhesus monkey) tissue sources were compared. The data indicate that MSCs isolated from rhesus bone marrow (rBMSCs) and human adipose tissue (hASCs) had more similar biologic properties than MSCs ofrhesus adipose tissue (rASCs) and human bone marrow MSCs (hBMSCs). Analyses of in vitro growth kinetics revealed shorter doubling time for rBMSCs and hASCs. rBMSCs and hASCs underwent significantly more population doublings than the other MSCs. MSCs from all sources showed a marked decrease in telomerase activity over extended culture; however they maintained their mean telomere length. All of the MSCs expressed embryonic stem cell markers, Oct-4, Rex-1 and Sox-2 for at least 10 passages. Early populations of MSCs types showed similar multilineage differentiation capability. However, only the rBMSCs and hASCs retain greater differentiation efficiency at higher passages. Overall in vitro characterization of MSCs from these two species and tissue sources revealed a high level of common biologic properties. The bone marrow and adipose tissue derived MSCs were then compared for the plasticity in vivo. In a time course study, the two types of MSCs were transplanted into the lateral ventricles of NIHIII immune deficient mice. The migration and engraftment of MSCs have been evaluated on 2, 4, and 6 weeks post engraftment. Our results indicated that while both cell types engrafted in multiple regions throughout the brain, the adipose tissue derived MSCs persisted in the brain for longer periods of time. The adipose tissue derived MSCs were detected up to six weeks post-transplantation. Since there is no ethical limitation on using adult stem cells, the results of this study suggest that adipose tissue and bone marrow will prove to be important sources of pluripotent stem cells.
Early Walking of Geriatric Amputees
Authors: M. B. Devas
Journal: BMJ (1971)

After amputation geriatric patients have been enabled to get up and walk with the help of a prosthesis, an "early walking aid." The physiotherapist measures the patient, fits the early walking aid, and instructs him in walking. The prosthesis is simple to make, easy to apply, and allows early walking with the use of a walking frame or sticks. Thus the geriatric amputee can walk as soon after operation as his general condition allows and the surgeon wishes.
THE TREATMENT OF RHEUMATISM BY SPECIFICS.
Authors: N. S. DAVIS
Journal: JAMA (1907)

I was asked to discuss the specific treatment of acute articular rheumatism or that kind of treatment which is supposed to combat the cause or neutralize the toxins of the disease. Unless we know the cause of a disease, and are convinced that a certain remedy destroys that cause or neutralizes it, we can not call a remedy a specific. Therapeutists, however, were certain that mercury was a specific for syphilis and quinin for malaria before all this information had been obtained in regard to these diseases. As yet we have not the requisite knowledge of the cause of rheumatism which would enable us to say with positiveness that there is a specific for the disease, although the salicylates possess many of the attributes of one. Almost from the time that rheumatism was clearly recognized its cause has been believed to be a noxious foreign agent in the blood and
Abstract LB-192: <i>In vivo</i> zebrafish tyrosine kinase assay for anti-cancer drug screening
Authors: Chun-Qi Li
Journal: Cancer Research (2010)

Abstract Discussion Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-192.
Care of Women Infected With the Human Immunodeficiency Virus
Authors: Howard L. Minkoff
Journal: JAMA (1991)

<h3>Objective.</h3> —To review current knowledge regarding human immunodeficiency virus (HIV) infection in women and to derive from that data standards of care. <h3>Data Sources.</h3> —Selective review of pertinent articles addressing cervical disease, pelvic inflammatory disease, sexually transmitted diseases, contraception, and pregnancy in HIV-infected women. A computer-assisted search was used to identify relevant articles on pharmacokinetics of drugs in women and oral contraceptive—drug interactions. <h3>Data Extraction.</h3> —Pertinent data were abstracted from case-control, cohort studies, clinical trials, and pharmacokinetic studies. <h3>Data Synthesis.</h3> —Few studies have been performed to define the clinical course of HIV infection in women. Gender-specific manifestations, such as cervical neoplasia, pelvic inflammatory disease, and vaginal moniliasis, appear to pursue a more aggressive course in HIV-infected women. Little is known about the pharmacokinetics of drugs for HIV and related infections. Oral contraceptives may alter the metabolism of some drugs used in HIV-infected women. An approach to the routine treatment of HIV-infected women is summarized. <h3>Conclusions.</h3> —Little is currently known regarding the natural course of HIV infection in women. Women infected with HIV should be followed up frequently with specific attention paid to the reproductive system. Additional studies should be conducted to determine the impact of HIV on gender-specific diseases. (<i>JAMA</i>. 1991;266:2253-2258)
Representation on the Joint Consultants Committee
Authors: S. Simmons
Journal: BMJ (1972)

We were also surprised to find in Bennett and Porter's data that clearances repeated one hour after an initial study during con- stant plasma inulin concentration and urine flow showed marked discrepancy between initial clearance and subsequent clearance in some patients.For example, one normal subject's inulin clearance went up from 105 ml/min to 133 ml/min.The other patient's inulin clearance went down from 101 ml/ min to 76 ml/min.Glomerular filtration in man was found to be relatively constant throughout the 24-hour period when patients were confined to bed rest,8 and glomerular filtration rate in normal man is found to be remarkably constant on repeated measure- ment from day to day and from month to month over years.9If we believe the data reported by Bennett and Porter with hour-to-hour variations physicians will be hard put to follow the change of glomerular filtration rate of patients with renal disease by either inulin clearance or endogenous creatinine clearance.-We are, etc.,
Subgroup Variation in Diagnostic Test Evaluation
Authors: Stephanie A. Mulherin, William C. Miller
Journal: Annals of Internal Medicine (2003)

Letters15 April 2003Subgroup Variation in Diagnostic Test EvaluationStephanie A. Mulherin, MSPH and William C. Miller, MD, PhD, MPHStephanie A. Mulherin, MSPHUniversity of North Carolina at Chapel Hill; Chapel Hill, NC 27599 (Mulherin, Miller)Search for more papers by this author and William C. Miller, MD, PhD, MPHUniversity of North Carolina at Chapel Hill; Chapel Hill, NC 27599 (Mulherin, Miller)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-8-200304150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Evans raises an important point regarding the potential of reference test bias to masquerade as spectrum effect. Apparent spectrum effect may be observed under three conditions: 1) Test performance may actually differ across subgroups; 2) test performance may appear to differ across subgroups because of reference test bias and variation in prevalence; and 3) test performance may actually differ across subgroups but the observed effect may be exaggerated (or potentially reduced) by reference test bias and variation in prevalence. The magnitude of the bias in the last two circumstances depends on the prevalence in the subgroups, the ...Reference1. Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL, . Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections2002. MMWR Recomm Rep. 2002;51:1-38. [PMID: 12418541] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of North Carolina at Chapel Hill; Chapel Hill, NC 27599 (Mulherin, Miller) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSpectrum Bias or Spectrum Effect? Subgroup Variation in Diagnostic Test Evaluation Stephanie A. Mulherin and William C. Miller Subgroup Variation in Diagnostic Test Evaluation Arthur T. Evans Subgroup Variation in Diagnostic Test Evaluation Ronald R. Scobbo Metrics 15 April 2003Volume 138, Issue 8Page: 686-687KeywordsAge groupsChlamydia infectionInfectious diseasesLigasesSexually transmitted diseasesSpecificity ePublished: 15 April 2003 Issue Published: 15 April 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Usefulness of Urban Paramedics
Authors: Eric Alcouloumre
Journal: JAMA (1986)

<h3>To the Editor.—</h3> In their article, "The Urban Paramedic's Scope of Practice," Drs Smith and Bodai<sup>1</sup>state that paramedics should treat most prehospital emergencies by a "load-and-go" policy. Although some of their conclusions may be valid, they have presented data that are misleading, and therefore their conclusions require a second look. The most misleading piece of information pertains to the time it takes a paramedic to start an intravenous (IV) line in the field. Citing an article by McSwain et al,<sup>2</sup>they state that it has been demonstrated that the average time for starting an IV line in the field is 11 minutes. McSwain and co-workers' article, which reviewed 100 cases of resuscitation from cardiopulmonary arrest by paramedics, noted that patients in whom IV line placement was attempted spent additional time at the scene averaging about 12 minutes. The investigators in that study did not measure the time
John ("Jack") Ferens Turner
Authors: A. Turner
Journal: BMJ (2003)

Former general practitioner Bath (b 1930; q St Thomas's Hospital, London, 1962), died from multiple system atrophy on 25 September 2002.

Jack came to medicine late. He had won a scholarship to read classics at Cambridge but decided against doing so. After national service in the Royal Marines he worked as a land agent for the National Trust, and helped out in the family clothing business before embarking on a career in medicine. He was a keen walker, photographer, gardener, and naturalist. He leaves a wife, Anne, and three children.
MORE UNFAIR ADVERTISING BY HARROWER
Authors: Robert L. Schaefer
Journal: JAMA (1933)

<h3>To the Editor:</h3> —In a recent publication of the Harrower Company, an article appeared captioned "Harrower and Engelbach." This takes unfair advantage of the late Dr. William Engelbach. He not only would have resented but also clearly and definitely refuted any such association. I feel that my duty is to repudiate this form of advertising, and in so doing I am but voicing the resentment of his numerous medical friends, former students and associates. A major portion of Dr. Engelbach's life was devoted to teaching the general profession sound diagnostic and therapeutic endocrine medicine, in opposition to the illogical claims of hyperenthusiastic physicians and unscrupulous pharmaceutic houses. His medical prestige was self earned. He was never in accordance with this man's theories nor could he condone his methods of advertising to the profession.
Increasing the number of medical students from under-represented minorities
Authors: Phyllis L Carr, Kenneth C Edelin
Journal: BMJ (2006)

Innovative method needs to be replicated elsewhere 

B etter health care and a reduction in health disparities occur when the physician workforce is diverse in background, ethnicity, culture, and race.1 2 Unfortunately, there are not enough students from economically and educationally deprived backgrounds in the pipeline to achieve a sufficiently diverse physician workforce. A paper by Greenhalgh and colleagues in this issue describes an innovative and thoughtful approach of reaching and engaging these students.3 The project steering group used “partnering” schools and teachers in inner London to identify students from deprived backgrounds who had motivation and ability in the sciences. Teachers reaffirmed the problems the students needed to overcome to be successful in gaining a medical education: lack of self determination, lack of confidence, and …
Development of a cushion to prevent ischial pressure sores.
Authors: P Bowker, L M Davidson
Journal: BMJ (1979)

A study was carried out jointly by nursing staff and technologists in an attempt to develop a cushion based on scientific principles and measurement that might prevent pressure sores. At each stage in the development clinical trials were carried out, and using the results of these together with the opinions of medical staff and patients who used the cushion the design was suitably modified. Over four years a seat was evolved that was simple to construct and fulfilled the clinical requirements for a wide range of patients while providing maximum relief of high-pressure points. The design was subsequently taken up commercially.
The Therapeutic Management of Psychological Illness: The Theory and Practice of Supportive Care
Authors: Richard L. Grant
Journal: JAMA (1968)

After paying their respects to our heritage, psychoanalytic theory, the authors of this eminently practical book proceed to outline a pragmatic treatment program "emphasizing activity, reality, and structure" in the best tradition of a behaviorally oriented approach which deals with problem behavior in its full social matrix. The authors define psychological "illness" as simply the "behavior of a person identified as a patient." In another place they see "illness" as a "state of impairment of function"—without regard for who might define the impairment. The non-forward, constricting, or inappropriate behavior, as defined by the ill person or others around him, then becomes the "illness." With this definition, a change in the behavior becomes the remedy, a position the authors espouse operationally in the sections on practice, despite their earlier theoretical statements. Mendel and Green view hospitalization as an active treatment process. Because it, like many other strong treatments, has untoward side