tbuckley/cabot-search huggingface dataset:
The European working time directive for doctors in training
Authors: T. Pickersgill
Journal: BMJ (2001)

On 1 August 2004 junior doctors in the National Health Service and other healthcare systems throughout Europe will no longer be excluded from the provisions of the European Working Time Directive.1 Their working hours will then be limited by law, first to 58 hours a week and then, by 2009, to 48 hours. This will demand even more profound changes for the NHS than seen so far in the long march for better working conditions for junior hospital doctors.

The original directive on working time became law in 1993, but doctors in training were excluded, along with workers in the road, air, rail, sea, and inland waterway industries. The British government of the time challenged the validity of the directive as health and safety law, but it was confirmed in 1996 as such by the European Court of Justice.2 There is overwhelming …
High-Risk Groups — Definition and Identification
Authors: Ursula M. Anderson, Rachel Jenss, William E. Mosher, Clyde L. Randall, Edward Marra
Journal: New England Journal of Medicine (1965)

WHEN President Kennedy signed Public Law 88.156 on October 24, 1963, attention was focused on the urgent need to enlarge maternal and child-health services. The President's Panel on Mental Retardation, whose report1 provided the framework for Public Law 88.156, pointed to the fact that a reduction in the incidence of mental retardation would be achieved only by a comprehensive attack on all factors pertinent to child growth and human development. The report highlighted the fact that mental retardation and other disabilities were more frequent among groups receiving inadequate maternal and child-health services.2 3 4 5 This being so, it must be assumed that . . .
THE SPRINGS OF NEUROSIS
Authors: G. F. Walker
Journal: BMJ (1935)

JIUILAL 15 to 25 years) recently seen at Victoria Park, and nearly, all supplied some hint, not of what physical signs, but of what sputum test or skiagram would reveal.Rejecting six cases which were apparently of at least six months' duration when I first saw the patients, I note that thirty-seven out of the remaining forty-four had symptoms suggestive of tuberculosis.Thus--fourteen of these young persons .complained of cough' withexpectora-
RHINITIS IN CHILDREN; ITS VARIETIES, CAUSES AND TREATMENT.Read before the Illinois State Medical Society, May 15, 1893.
Authors: W. E. CASSELBERRY
Journal: JAMA (1893)

The forms of rhinitis which affect children are, in the main, subject to the same classification as when affecting adults. Various phases of the disease, however, both in pathology and clinical history, assume in childhood different degrees of importance, by reason of special tissue proclivities which are incidental to early life, and of unusual damage liable to ensue in a child from neglect of the disease during the developmental period. The treatment also requires special adaptation to the comparative helplessness and timidiy of young children. ACUTE RHINITIS. Acute rhinitis, colloquially termed "cold in the head," is an acute inflammation of the mucous membrane lining the nasal cavities from the anterior nares to the naso-pharnyx. It is prone to extend to adjoining mucous surfaces and usually embraces the naso-pharnyx, at least to some degree, and thence not infrequently also the middle ear. <i>Etiology</i>.—Reasoning from analogy, one must regard acute suppurative rhinitis
Hypotension after Quinidine plus Verapamil
Authors: Alan S. Maisel, Harvey J. Motulsky, Paul A. Insel
Journal: New England Journal of Medicine (1985)

VERAPAMIL is a calcium-channel blocking agent that has been used extensively in the treatment of coronary vasospasm1 and supraventricular arrhythmias.2 , 3 Its negative inotropic and chronotropic actions as well as its vasodilator effect make it useful in the treatment of other disorders, such as angina pectoris.4 As indications for the use of verapamil increase, the potential for its interacting with other drugs also increases. Thus, recent work has questioned the safety of combined therapy with β-blockers and verapamil,5 , 6 and occasional reports have described catastrophic results.7 , 8 We describe here three patients who became hypotensive after receiving oral quinidine and intravenous verapamil. We . . .
Attitudes Toward Autopsy and Organ Donation in Sweden and the United States
Authors: George D. Lundberg
Journal: JAMA (1994)

The autopsy in the United States has come upon hard times.<sup>1</sup>From a peak rate of nearly 60% of hospital deaths in the 1950s, we have dropped to a low of 12% in the 1990s and to under 5% in nonteaching community hospitals.<sup>2</sup> Organ transplantation is highly successful. Yet despite over 2 million deaths annually, more than 30 000 Americans are on waiting lists for organs.<sup>3</sup> See also p 284. What is the problem? Is it attitudes of the public? attitudes of physicians? resistance by pathologists? lack of money? communication difficulties? Or is it simply systematic incompetence? In this week's<i>JAMA</i>, Sanner of Uppsala<sup>4</sup>documents a study of attitudes among Swedes showing a more than 80% acceptance rate of autopsy for themselves or for a close relative; a more than 60% willingness to donate their own organs for transplantation and nearly 40% to donate those of
Signaling Pathways in Reactive Oxygen Species–Induced Cardiomyocyte Apoptosis
Authors: Rüdiger von Harsdorf, Pei-Feng Li, Rainer Dietz
Journal: Circulation (1999)

The importance of free radical homeostasis and apoptosis in normal and diseased hearts and their interrelationships are poorly defined. We tested whether reactive oxygen species can trigger apoptosis in cardiomyocytes, and we explored the underlying pathways.A cell culture model of isolated cardiac cells and different reactive oxygen species (ROS)-generating systems were used. Apoptosis became evident when cardiomyocytes were exposed to either H2O2 or superoxide anion (O2-). Both H2O2- and O2--induced apoptosis of cardiomyocytes were associated with an increase in p53 protein content, whereas protein levels of Bax and Bcl-2 were unaltered. H2O2, but not O2-, induced an increase in the protein content of Bad. Furthermore, H2O2 elicited translocation of Bax and Bad from cytosol to mitochondria, where these factors formed heterodimers with Bcl-2, which was followed by the release of cytochrome c, activation of CPP32, and cleavage of poly(ADP-ribose) polymerase. Interestingly, this pathway was not activated by O2-. Instead, O2- used Mch2alpha to promote the apoptotic pathway, as revealed by the activation of Mch2alpha and the cleavage of its substrate, lamin A.Taken together, these results indicate that ROS may play an important pathophysiological role in cardiac diseases characterized by apoptotic cell death and suggest that different ROS-induced activations of the apoptotic cell death program in cardiomyocytes involve distinct signaling pathways.
Abstract 467: Mitochondrial dynamics regulates migration and invasion of breast cancer cells
Authors: Yaping Tu, Jing Zhao, Juan Zhang, Meifang Yu, Dennis W. Wolff, Peter W. Abel
Journal: Cancer Research (2012)

Abstract Mitochondrial structure is dynamically regulated by fusion and fission events that are essential for maintaining physiological functions of cells. Although dysfunction of mitochondria has been implicated in tumorigenesis, little is known about the roles of mitochondrial dynamics in metastasis, the major cause of cancer death. In the present study, we found that mitochondria were more fragmented in metastatic breast cancer cells that express higher levels of mitochondrial fission protein dynamin-related protein 1 (Drp1) and less mitochondrial fusion protein 1 (Mfn1). Silence of Drp1 or overexpression of Mfn1 resulted in mitochondria elongation and significantly suppressed metastatic abilities of breast cancer cells. In contrast, silence of Mfn proteins led to mitochondrial fragmentation and enhanced metastatic abilities of breast cancer cells. Interestingly, these manipulations of mitochondrial dynamics had no significant effects on overall mitochondrial bioenergetics but altered the subcellular distribution of mitochondria in breast cancer cells. Silence of Drp1 or overexpression of Mfn1 inhibited lamellipodia formation, a key step for cancer metastasis, and suppressed chemoattractant-induced recruitment of mitochondria to lamellipodial regions. Conversely, silence of Mfn proteins caused accumulation of more mitochondria in lamollipodia regions with higher mitochondrial membrane potential, an indication of higher ATP synthesis. Treatment with the ATP uncoupling agent m-chlorophenylhydrazone (CCCP) or mitochondrial ATP synthesis inhibitor oligomycin A caused disappearance of lamellipodia and decreased breast cancer cell migration and invasion. Together, our findings show a new mechanism for regulation of cancer cell migration and invasion by mitochondrial dynamics. Thus targeting mitochondrial dynamics may provide a novel strategy for suppressing breast cancer metastasis. This work was supported by the National Institutes of Health (CA125661), State of Nebraska Research Fund (Grant LB595), the National Natural Science Foundation of China (31100973) and the National Basic Research Program (2010CB833701, 2012CB934003). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 467. doi:1538-7445.AM2012-467
Thrombopoietin/MPL participates in initiating and maintaining RUNX1-ETO acute myeloid leukemia via PI3K/AKT signaling
Authors: John Anto Pulikkan, Dmitri Madera, Liting Xue, Paul Bradley, Sean Francis Landrette, Ya-Huei Kuo, Saman Abbas, Lihua Julie Zhu, Peter Valk, Lucio Hernán Castilla
Journal: Blood (2012)
Use of Services by Diabetes Patients in Managed Care Organizations: Development of a diabetes surveillance system
Authors: Michael M Engelgau, Linda S Geiss, Diane L Manninen, Carlyn E Orians, Edward H Wagner, Neal M Friedman, Judith S Hurley, Kathryn M Trinkaus, Deborah Shatin, Krista A Van Vorst
Journal: Diabetes Care (1998)

To develop a diabetes surveillance system that estimates the prevalence of diabetes and characterizes service use in diverse managed care organizations (MCOs).Computerized inpatient, pharmacy, outpatient, and laboratory records were used to develop an algorithm to identify diabetes patients and to develop surveillance indicators common to the three participating MCOs. Using 1993 data, the availability, specifications, and limitations of various surveillance indicators were determined.An extensive set of diabetes surveillance indicators was identified from the four sources of data. Consistent data specifications across MCOs needed to consider variation in the type of data collected, a lack of documentation on level of coverage, differences in coding data, and different models of health care delivery. A total of 16,363 diabetes patients were identified. The age-adjusted prevalence of diabetes ranged from 24 to 29 per 1,000 enrollees. Approximately one-third of patients with diabetes (32-34%) were taking insulin. The majority had one or more visits to a primary care physician during the year (72-94%). Visits to specialists were less frequent. Ophthalmologists and optometrists were the most commonly used specialists: 29-60% of the patients with diabetes at the three MCOs had visited an ophthalmologist or optometrist. About one-fifth had an overnight hospital stay during the year.This diabetes surveillance system is a useful tool for MCOs to track trends in prevalence of diabetes, use of health services, and delivery of preventive care to individuals with diabetes. This system may also be useful for health care planning and for assessing use changes after new developments in diabetes care or new quality management initiatives.
Central sleep apnea is associated with increased ventilatory response to carbon dioxide and hypersecretion of growth hormone in patients with acromegaly.
Authors: R R Grunstein, K Y Ho, M Berthon-Jones, D Stewart, C E Sullivan
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Although obstructive sleep apnea (OSA) occurs commonly in acromegaly, we have recently reported an unexpectedly high prevalence of central sleep apnea (CSA) in these patients. Acromegalic patients with CSA have increased growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels compared with their counterparts with OSA. Studies in animals, normal humans, and patients with sleep apnea have suggested that CSA is associated with increased gain of the respiratory control system. To examine the relationship between sleep apnea, respiratory control, and hormonal activity in acromegaly, we performed sleep studies and examined ventilatory responses to hypoxia at resting CO2 (HVR) and 8 mm Hg above resting CO2 (HHVR) and hypercapnia (HCVR) in 54 patients with acromegaly who also underwent detailed endocrine evaluation. Patients with CSA (n = 11) had higher HCVR (3.47 +/- 0.57 L/min/mm Hg) than did patients with obstructive sleep apnea (OSA) (1.86 +/- 0.19, n = 33) and patients without sleep apnea (1.77 +/- 0.21, n = 10). Measures of ventilatory control were all correlated with the mean of 12 hourly GH concentrations, but only HCVR was correlated with IGF-1 levels. Multiple linear regression analysis revealed that HCVR, HHVR, and IGF-1 could explain 39% of the variability in the degree of CSA in acromegalic patients with sleep apnea. We conclude that increased ventilatory responsiveness and elevated hormonal parameters of disease activity both contribute to the pathogenesis of central sleep apnea in acromegaly.
Tinea facei due to Microsporum canis in an Eight-Day-Old Infant
Authors: Alvin H. Jacobs
Journal: JAMA (1972)

To the Editor.—  This superficial Microsporum canis infection in an 8-day-old infant is thought to have occurred in the youngest patient yet to be reported. While moniliasis in newborns is not uncommon, superficial dermatophyte infections of infants is quite rare.  Report of a Case.—  An infant boy born Oct 22, 1970, was the third child of a healthy 24-year-old mother. Labor and delivery were uneventful, and the infant appeared normal at birth. Mother and infant left the hospital two days following delivery. On the eighth day, the mother noted a circular lesion on the infant's forehead which gradually enlarged and became more inflamed. On the 20th day, there was a circular lesion on the forehead measuring 1 × 0.5 cm. Inflammation was moderate, the border elevated and vesicular with a scaly flat central portion (Fig 1). A KOH preparation taken from the active border demonstrated hyphae. Treatment consisted of liquid
Mycobacterium tuberculosis DNA in tissue affected by sarcoidosis.
Authors: H M Fidler, G A Rook, N M Johnson, J McFadden
Journal: BMJ (1993)

OBJECTIVE--To investigate the prevalence of Mycobacterium tuberculosis DNA in granulomatous tissues from patients with sarcoidosis and from controls matched for age, sex, and tissue by using the polymerase chain reaction. DESIGN--Single blind control trial. SUBJECTS--16 patients with sarcoidosis who had undergone diagnostic biopsy of lung, skin, or lymph node and 16 patients with squamous cell carcinoma or Hodgkin9s disease to act as controls. In addition, four lung specimens infected with M tuberculosis were included as positive controls. RESULTS--M tuberculosis DNA was present in sarcoid tissues containing granulomas from seven of the 16 patients and one of the 16 matched controls. Two of the four specimens known to be infected with M tuberculosis were positive in the controlled experiment. CONCLUSION--These figures suggest that M tuberculosis DNA is detected as readily in patients with sarcoidosis as in patients with frankly tuberculous tissues and imply that M tuberculosis may be linked to the cause of sarcoidosis.
Splenic Infarction: an Unusual Complication of Ethanolamine Oleate Injection
Authors: A. Bar-Gil Shitrit, D. Aharoni, S. Zeides, D. Braverman
Journal: Endoscopy (2006)

Sclerotherapy with ethanolamine oleate is an acceptable approach for treating esophageal varices, peptic ulcer disease, and Dieulafoy’s lesions. Most of the reported complications associated with ethanolamine oleate have been anecdotal and include portal/mesenteric vein thrombosis [1], hepatotoxicity [2], acute renal failure [3], purulent meningitis [4], noncardiogenic pulmonary edema [5], spinal cord paralysis, and disseminated intravascular coagulation. We report here a patient with a Dieulafoy’s lesion in whom treatment with ethanolamine oleate injection was complicated by splenic infarction. To the best of our knowledge, no similar cases have previously been reported. This report should alert endoscopists to the potential risks of ethanolamine oleate injection in the treatment of bleeding vessels.
Criteria for Screening Blood Donors: Science or Politics?-Reply
Authors: Steven H. Kleinman
Journal: JAMA (1997)

<h3>In Reply.</h3> —Dr Murphy presents a challenging scenario regarding current blood donor qualification criteria. Our study was designed to quantitate and characterize behavioral risks in blood donors based on current screening regulations and standards established by both the Food and Drug Administration (FDA) and the blood collection community.<sup>1,2</sup>These deferral criteria were based on the best scientific and media analysis of risk available at the time and were designed to exclude individuals who may be in the serological "window period" of an early transfusion-transmissible infection—undetectable by current blood screening tests. Deferrals were also designed to avoid collection of infectious units expected to test positive to protect phlebotomists and laboratory workers who draw and test the blood and to prevent the accidental release from quarantine of an infectious unit. Determination of the number of prior sexual partners of donors has been investigated previously and has not proven to be a scientifically valid
Evidence based publishing
Authors: Leanne Tite, Sara Schroter
Journal: BMJ (2006)

OBJECTIVE: To assess the mechanism of miR-155 control of autoimmune demyelination. BACKGROUND: MicroRNAs (miRNA) are small, endogenous, single stranded RNA that represent a novel group of non-protein coding gene products. MicroRNAs play an important gene-regulatory roles by influencing transcription, degradation oractivation of mRNA produced by classical genes. MicroRNAs have been implicated as a regulatory principle in the immune system and miR-155 has been found to play particularly important role in various immune cell function. We and others have described a miR-155 upregulation in T helper cells during development of the experimental autoimmune encephalomyelitis (EAE), an animal model of MS. DESIGN/METHODS: To manipulate the miR-155 activity a set of specific oligonucleotide mimics and antagomir inhibitors was used. Active myelin antigen immunization EAE model and myelin specific Th transfer model have been assessed. To validate the impact of the in vivo loss of miR-155 on EAE a miR-155 deficient and sufficient mice have been utilized. RESULTS: We have found, in concert to previous reports, that miR-155 deficient mice are resistant to active EAE induction. The myelin autoantigen, MOG peptide 35-55, immunization of miR-155 deficient mice led to decreased generation of the Th1 and Th17 responses. Conversely, miR-155 deficient mice presented increased Th2 profile. In a search for molecular mechanisms of miR-155 action in T cells we have analyzed a gene expression profiles of miR-155 deficient T helper cells. Intriguingly we have found that most upregulated genes in miR-155 deficient were two genes of heat shock protein 40 chaperone family, Dnaja2 and Dnajb1. These two genes were also upregulated in T helper cells following a miR-155 antagomir treatment. Finally, a MOG TCR transgenic T helper cell transfected with either Dnaja2 or Dnajb1 were less encephalitogenic in an EAE transfer model. CONCLUSIONS: Our results provide evidence for specific and selective role of miR-155 in the process of myelin antigen adaptive response and autoreactive T cell development via targeting of the hsp40 genes expression levels. <b>Disclosure:</b> Dr. Mycko has nothing to disclose. Dr. Cichalewska has nothing to disclose. Dr. Cwiklinska has nothing to disclose. Dr. Selmaj has received personal compensation for activities with Biogen Idec, Genzyme Corp., Ono Pharmaceutical, Novartis, Bayer Pharmaceuticals Corp., Hoffmann La-Roche, Merck Serono and Synthon.
“Humanities are the Hormones:” Osler, Penfield and “Neuroethics” Revisited
Authors: Joseph J. Fins
Journal: The American Journal of Bioethics (2008)

Click to increase image sizeClick to decrease image size ACKNOWLEDGEMENTS Dr. Fins is the recipient of an Investigator Award in Health Policy Research (Minds Apart: Severe Brain Injury and Health Policy) from The Robert Wood Johnson Foundation. He also gratefully acknowledges grant support from the Charles A. Dana Foundation (Mending the Brain, Minding our Ethics II) and the Buster Foundation (Neuroethics and Disorders of Consciousness).
Unilateral somatic symptoms due to hyperventilation.
Authors: J N Blau, C M Wiles, F S Solomon
Journal: BMJ (1983)

Unilateral somatic symptoms due to hyperventilationRecurrent unilateral sensory or motor symptoms (or both) are a poorly recognised presentation of the hyperventilation syndrome.We have seen 12 such cases during the past two years and here describe two cases in detail and 10 in tabular form. Case reportsCase 1-A 19 year old school leaver unable to find work gave a six month history of recurrent episodes of numbness and weakness of her left hand and arm.Each episode lasted a few minutes and she simultaneously felt dizzy, light headed, had difficulty taking a deep breath, and felt tightness in the chest.Investigation elsewhere for suspected epilepsy proved negative.Physical examination showed no abnormality, though she was overtly anxious: voluntary hyperventilation reproduced all her symptoms.She was reassured and the mechanism explained.A physiotherapist taught her breathing exercises, which she continued for a few weeks.When reviewed two years later she was well without recurrence of symptoms.Case 6-A 30 year old male banker had had intermittent paraesthesiae affecting the left face, arm, and leg for four months.Episodes lasted several minutes and could recur up to three times a week.He was referred with suspected cerebrovascular disease.Physical examination showed no abnormality but he was anxious about his job.Voluntary hyperventilation reproduced his attacks but no other symptoms such as dizziness.After explanation he was taught breathing exercises by a physiotherapist and remained free of symp- toms when reviewed two years later.'Tavel ME.Hyperventilation syndrome with unilateral somatic symptoms.