tbuckley/cabot-search huggingface dataset:
How to halt the brain drain
Authors: Imre Loefler
Journal: BMJ (2006)

S ome say that to take away doctors and nurses from the developing world is a crime. But why are there currently so many overseas doctors and nurses in Britain, for example, and why does such a large proportion of NHS staff come from the developing world?

There are several good reasons: the niche is becoming increasingly larger as health care has become the largest industry; the British government is spending so much money on the NHS; because of the European Working Time Directive there is a need for more doctors; British health professionals are becoming increasingly demoralised and humiliated by politicians and managers; and young Britons do not aspire to become doctors or nurses any more. There is another reason: the peoples of the former British colonies outnumber those of the French, Spanish, Portuguese, Dutch, and Danish put together, they speak English, and they went to medical and nursing schools that followed in principle the tradition of British medical education and training. …
Case fatality rates for meningococcal disease in an English population, 1963-98: database study
Authors: M. J Goldacre
Journal: BMJ (2003)

Our study has several limitations.Answering questions about a sensitive topic on the telephone can be difficult, a questionnaire with a fixed choice of answers prevented doctors from qualifying or justifying their responses, and we lacked detailed information about doctors who did not respond.Previous studies found similar patterns, but the French counterparts to Italian general practitioners and US oncologists were more in favour of legalising euthanasia. 3 4Our findings contradict the argument that opinions on euthanasia are related to cultural differences in English speaking countries; comparative studies are needed. 2 In France, the support shown for euthanasia may be due to a lack of professional knowledge on palliative care. 5Improving such knowledge would improve end of life care and may also clarify the debate over euthanasia.
Weaning Patients from Mechanical Ventilation Using Gastric pH
Authors: Martin J. Tobin
Journal: Annals of Internal Medicine (1994)

Letters1 March 1994Weaning Patients from Mechanical Ventilation Using Gastric pHMartin J. Tobin, MDMartin J. Tobin, MDLoyola University of Chicago Stritch School of Medicine; Maywood, IL 60153Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-5-199403010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In contrast to our finding [1], Mohsenifar and colleagues [2] found respiratory frequency, tidal volume, and the ratio of frequency/tidal volume to be poor predictors of weaning failure. In their important paper on the methodologic standards used in studies of predictive indexes, Wasson and colleagues [3] emphasized the need for investigators to follow the original protocol, but Mohsenifar and associates fell short. First, frequency and tidal volume were measured at 20 to 30 minutes into the weaning trial rather than at the beginning of the trial. Second, they failed to indicate 1) the instrumentation used to measure ...References1. Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med. 1991; 324:1445-50. Google Scholar2. Mohsenifar Z, Hay A, Lewis MI, Koerner SK. Gastric intramural pH as a predictor of success or failure in weaning patients from mechanical ventilation. Ann Intern Med. 1993; 119:794-8. Google Scholar3. Wasson JH, Sox HC, Neff RK, Goldman L. Clinical prediction rules: applications and methodological standards. N Engl J Med. 1985; 313: 793-9. Google Scholar4. Nathan SD, Ishaaya AM, Koerner SK, Belman MJ. Prediction of minimal pressure support during weaning from mechanical ventilation. Chest. 1993; 103:1215-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: Loyola University of Chicago Stritch School of Medicine; Maywood, IL 60153 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWeaning from Mechanical VentilationWeaning and extubation in the intensive care unit 1 March 1994Volume 120, Issue 5Page: 438-439KeywordsBreathingTidal volumeVentilatorsWeaning ePublished: 15 August 2000 Issue Published: 1 March 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Tumor Variation in Families With Breast Cancer
Authors: Henry T. Lynch
Journal: JAMA (1972)

This study documents types of malignant neoplasms found in members of 34 families who were selected for investigation because of their having two or more members affected with breast cancer. The data indicate that the members of some families with familial breast cancer have a relatively high predisposition for cancer of the colon, while the members of other families with familial breast cancer show relatively high predispositions, respectively, for gastric, ovarian, and endometrial carcinoma, and some for a complex of brain tumors, sarcoma, and leukemia. The observations are consistent with concepts of multiple causes involving the interactions of different genetic and environmental factors that structure different patterns of tumor association and predisposition.
The isolated prolonged PTT
Authors: Oxana Tcherniantchouk, Michael Laposata, Marisa B. Marques
Journal: American Journal of Hematology (2012)

It is increasingly difficult to choose the proper tests to investigate an abnormal laboratory result, delaying the time to reach the correct diagnosis and increasing the cost of care. A wrong choice may also lead to clinically significant errors, which can be life threatening. To show how errors in test selection occur in routine medical practice, the authors describe an algorithm to evaluate patients with a prolonged activated partial thromboplastin time (PTT) and a normal prothrombin time. This exercise challenges the commonly held belief that errors in laboratory utilization occur primarily with esoteric and/or genetic testing, rather than in patients with common abnormalities such as a prolonged PTT.
Distension in non-consulting dyspeptics: a swell idea
Authors: J TACK
Journal: Gut (2000)

See article on page 332 

Functional dyspepsia is a clinical syndrome defined by chronic or recurrent symptoms of pain or discomfort centred upon the upper abdomen without a cause being identified by conventional diagnostic means.1 The pathophysiology of functional dyspepsia is unknown but a number of mechanisms have been proposed, such as delayed gastric emptying, hypersensitivity to gastric distension, impaired accommodation to a meal, Helicobacter pylori gastritis, or central nervous system dysfunction.

Dyspeptic symptoms occur in approximately 25% of the general population and only about one quarter of these seek medical attention.2 The reasons underlying health care seeking behaviour in functional dyspepsia are unknown, and may relate both to symptom severity and psychological factors.2 Except for the possible involvement of H pylori , the symptom pattern and underlying mechanisms in non-consulters with dyspepsia have received little attention. Recent developments of less invasive techniques, such as gastric emptying breath tests or a caloric satiety test,3 may facilitate studies in non-consulting subjects in the general population.

Because of its presumed pivotal role in the occurrence of functional gastrointestinal disorders, visceral sensitivity and its modulation is a topic of intense ongoing research. In this issue of Gut , Holtmann and colleagues used a gastric barostat procedure …
Effect of red cell exchange transfusion on plasma levels of inflammatory mediators in sickle cell patients with acute chest syndrome
Authors: Robert I. Liem, Maurice R. O'Gorman, Deborah L. Brown
Journal: American Journal of Hematology (2004)

Red cell exchange transfusion is the recommended therapy for patients with sickle cell disease (SCD) who have severe, progressive acute chest syndrome (ACS). A double-volume red cell exchange transfusion decreases the percentage of hemoglobin S (Hgb S) containing red blood cells to less than 20%, improving vascular perfusion. We speculated that reduction of pro-inflammatory mediators might also contribute to the therapeutic effect of an exchange transfusion. We measured white blood cell count (WBC), absolute neutrophil count (ANC), platelet concentration as well as plasma levels of interleukin-1alpha (IL-1alpha), interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), interleukin-8 (IL-8), and soluble vascular cell adhesion molecule-1 (sVCAM-1) in 8 sickle cell patients with 9 episodes of ACS who received a manual, double-volume exchange transfusion. Six patients with SCD seen during a routine clinic visit were used as controls. The mean number of hospitalization days was 6, with an average of 2 days in the intensive care unit. All patients recovered without complication. Sickle cell patients with ACS had a higher WBC and ANC at baseline but lower sVCAM-1 levels compared to controls. TNF-alpha, IL-1alpha, IL-1beta, and IL-8 levels were not significantly different from controls. WBC, ANC, platelet, and sVCAM-1 measurements were significantly decreased immediately post-exchange in patients with ACS; however, this effect was not persistent as levels trended towards pre-exchange values by 24 hr post-exchange. Due to wide inter-individual variability, a consistent pattern was not seen for TNF-alpha, IL-1alpha, IL-1beta, or IL-8. We conclude that in sickle cell patients with ACS, a manual, double-volume exchange transfusion lowers WBC, ANC, platelets, and sVCAM-1 levels, but the effect is short-lived.
Pathological Effects of Extensive Radiofrequency Energy Applications in the Pulmonary Veins in Dogs
Authors: Gregg W. Taylor, G. Neal Kay, Xiangsheng Zheng, Sanford Bishop, Raymond E. Ideker
Journal: Circulation (2000)

Introduction —The long-term complications of catheter ablation within the pulmonary veins are unknown. The development of pulmonary vein stenosis has recently been described after catheter ablation to treat either chronic or paroxysmal atrial fibrillation. The purpose of this study was to examine the pathological and hemodynamic effects of radiofrequency (RF) energy application within the pulmonary veins. Methods and Results —Right heart and transseptal catheterization were performed in 9 anesthetized mongrel dogs. The pulmonary vein ostia were cannulated and pulmonary venous pressure was measured before RF energy application in up to 4 separate pulmonary veins. Animals were euthanized at intervals of 2 to 4 weeks (n=3), 6 to 8 weeks (n=3), or 10 to 14 weeks (n=3) after ablation. Repeat catheterization before euthanasia demonstrated statistically significant differences in pulmonary capillary wedge pressure, cardiac output, pulmonary vascular resistance, and systemic vascular resistance ( P &lt;0.05) compared with the baseline. Luminal narrowing was observed in 22 of 33 pulmonary veins to which RF energy was applied. Of these, 7 were totally occluded, 7 had severe stenosis, and 8 were only minimally narrowed. Histological examination revealed intimal proliferation with organizing thrombus, necrotic myocardium in various stages of collagen replacement, endovascular contraction, and a proliferation of elastic lamina. Conclusions —Applications of RF current within the pulmonary veins may result in pulmonary vein narrowing or complete occlusion. These observations should be considered in treatment of arrhythmias originating within the pulmonary veins.
Good doctor, bad doctor---a psychodynamic approach
Authors: J. Holmes
Journal: BMJ (2002)

Let's face it—we doctors aren't saints. Have we not all sometimes felt bored and irritated by certain patients, longing for the consultation to end? Can any doctor honestly say that he or she has never felt a flicker of sexual interest in a patient? Have we never—and post-Shipman it is very difficult to say this—imagined the death of certain patients and the relief that would bring, not just to them but to us, their impotent carers? Do we not at times resent the demands of people for whom illness seems to have become a way of life? Whose thoughts have not sometimes drifted off towards their own concerns—to the need for sleep, food, or distraction or to some family, career, or future plans?

We are merely using our patients to bolster our own fragile sense of competence and health 

Moreover, perhaps rather than being motivated by altruism and scientific integrity, we are merely using our patients …
The Neuroendocrinology of Human Reproduction: Biological and Clinical Perspectives
Authors: Gretajo Northrop
Journal: JAMA (1972)

This small volume does precisely what its title indicates—it provides highlights of biological and clinical perspectives in reproductive neuroendocrinology. The book suffers only minimally from the problem of time lag between discovery and publication of fact. It merits serious consideration for the clinician or scientist interested in expanding his background and updating his thoughts about the science of reproduction in 1972. The reader will do well to survey initially the superlatively written first and last chapters, for Dr. Seymour Reichlin has, in the first chapter, skillfully provided a platform upon which to build a knowledge of neuroendocrinology, and in the last he has summed up many of the current concepts on the neuroendocrinology of reproduction. In addition, he has clearly focused on some of the problems to which the scientific community must address itself. The intervening chapters contain a brief but excellent survey of material, well written and worth reading,
Abstract 5194: Heterogenous expression of chemokine receptors in primary patient-derived GBM lines; association of CXCR3, CXCR4, and CXCR7 with a slow cycling sub-population
Authors: Kien Pham, Che Liu, Defang Luo, Brent A. Reynolds, Jeffrey K. Harrison
Journal: Cancer Research (2012)

Abstract WHO class IV glioblastoma multiforme (GBM) is one of the most malignant and aggressive forms of primary brain tumors and despite multimodal treatments patients have modest survival rates. The poor prognosis and therapy resistance of glioblastoma are believed to be a consequence of a subpopulation of glioma stem-like cells. As such, targeting functions associated with this cell population is likely to yield new therapeutic strategies. Roles for CXCR3, CXCR4, and CXCR7 in glioblastoma are well documented although previously published studies involved primarily the characterization of glioma cell lines grown in the presence of serum. Our studies were undertaken to understand the roles of chemokine receptors CXCR4 and CXCR7, and their ligands CXCL11 and CXCL12, in modulating glioblastoma stem-like cell functions. Tumors xenografts developed from patient-derived primary GBM cells cultured as gliomaspheres in serum-free conditions expressed CXCR4, CXCR7, CXCL11, and CXCL12 in a manner similar to expression patterns of these genes in human GBM tissues. Flow cytometry analysis of CXCR4 and CXCR7 on various patient-derived primary GBM lines indicated marked heterogenous expression of these receptors. Variable percentages of CXCR4+, CXCR7+, and CXCR4+/CXCR7+ (double positive) populations were evident. In contrast, chemokine receptors CCR3 and CXCR3 were co-expressed on a small but similar percentage of cells in all cell lines. RT-PCR indicated that all lines expressed CXCL11 while none expressed CXCL12. A slow cycling sub-population of cells, which express stem-like cell markers and exhibit high tumorigenic frequencies, were enriched for CXCR3, CXCR4, and CXCR7. CXCR4+ and CXCR7+ subpopulations were capable of forming spheres in serum-free culture conditions and exhibited plasticity in regenerating the cellular heterogeneity of their parental phenotype. In addition, both CXCR4+ and CXCR7+ cells were able to initiate the formation of intracranial tumors. In vitro functional studies showed that while CXCL12, but not CXCL11, stimulated the migration of GBM cell lines, both of these ligands were able to promote short-term proliferation. Collectively, the results suggest that CXCR4 and CXCR7 may regulate the stem-like properties of GBM cells. The high degree of heterogeneity in CXCR4 and CXCR7 expression both within and between glioblastomas suggests that personalized treatment of glioblastoma patients using selective antagonists that target CXCR4 and CXCR7 may need to consider the complex expression patterns and specific functions of these receptors. 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 5194. doi:1538-7445.AM2012-5194
Abstract 4827: Humanized hepsin neutralizing antibody RO5486055 inhibits tumor growth and leads to accumulation of hepsin substrate laminin-332
Authors: Sherif Daouti, Zoran Filipovic, Alvin Stern, Christine Tardell, Xiaolei Zhang, Debra Lucas-McGady, Brian Higgins, Kuo-Sen Huang, Ueli Gubler, Ying Li, Windy Berkofsky-Fessler, Julie Hang, Gennady Samokhin, Annette Seidl, Huifeng Niu, James Cai, Holly Hilton, Markus Thomas, Chandra Pamulapati, Olaf Mundigl, Silke Hansen, David C. Heimbrook, Kathryn E. Packman
Journal: Cancer Research (2012)

Abstract Hepsin is overexpressed in prostate and other cancers where it is implicated in promoting tumor growth, invasion, and metastasis. To further our understanding of the role of hepsin in prostate and breast cancer, a fully humanized monoclonal antibody that recognizes human and cynomolgus hepsin has been developed. RO5486055 selectively binds to hepsin but not related type II transmembrane serine proteases, and neutralizes hepsin serine protease activity with an IC50 in the single digit nM range. In LNCaP prostate cancer cells, both shRNA knockdown of the hepsin gene and RO5486055 treatment cause a similar accumulation of the β3 chain of laminin-332, a known hepsin substrate. With ip administration in mice, RO5486055 demonstrates dose-dependent exposure and a long serum half-life of 168-406 hours. RO5486055 attenuates tumor growth in the LNCaP prostate cancer and T-47D breast cancer xenograft models, but not in the CRW-22Rv1 prostate or MCF-7 breast cancer xenografts. In these models, it has been shown that the level of the β3 chain of laminin-332 detected by Western blot analysis predicts sensitivity to RO5486055-mediated growth inhibition. Moreover, accumulation of the β3 chain during RO5486055 treatment correlates with antitumor activity. In 8/10 hepsin-expressing patient-derived prostate tumors, an inverse correlation between hepsin and β3 chain expression is observed. The β3 chain of laminin-332 may therefore be useful as both a predictive and response biomarker for anti-hepsin therapy. RO5486055-mediated tumor growth inhibition is enhanced by combination with the EGFR-targeted antibody cetuximab in LNCaP prostate cancer xenografts, and by combination with hormone withdrawal in T-47D breast cancer xenografts. These preclinical results suggest that hepsin-directed therapy could be effective in prostate and breast cancer treatment. 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 4827. doi:1538-7445.AM2012-4827
Physicians promoting physical activity using pedometers and community partnerships: a real world trial
Authors: Linda Trinh, Ron Wilson, Heather MacLeod Williams, Alison J Sum, Patti-Jean Naylor
Journal: British Journal of Sports Medicine (2011)

Background Healthcare providers are a primary source of information on preventive health issues for patients. Further research related to physical activity (PA) promotion in the primary care setting is needed. Objective To explore the feasibility of a physician and community PA intervention using a pedometer for: increasing PA levels among inactive patients; enhancing relationships between physicians and community PA partners; and influencing the PA promotion habits of physicians. Methods A 6-week PA intervention was delivered to 152 inactive patients who were recruited in physician waiting rooms, counselled by their physicians, provided with a pedometer and referred to a community action site (CAS) at their local recreation centre for further support. PA was measured at baseline and follow-up using the International Physical Activity Questionnaire. Follow-up interviews were conducted with physicians and recreation representatives on the challenges and benefits associated with the intervention. Results Study patients significantly increased their PA (103% change in MET min/week). Physicians and recreation professionals were highly satisfied with the intervention and partnership. There were challenges to ongoing communication. Physicians reported increased awareness of the pedometer and community resources as supports for PA. Conclusion A pedometer-based PA intervention delivered by physicians in partnership with a community PA stakeholder is feasible and warrants further research. Long-term maintenance of this intervention would require resources for pedometers, and ongoing contact and communication between the physicians and CAS to ensure availability of community supports.
821 GLUTAMINE SYNTHETASE (GS) IMMUNOREACTIVITY CORRELATES WITH PATHOLOGICAL FEATURES OF HCC AND PREDICTS TUMOR-SPECIFIC SURVIVAL AFTER RFA ABLATION
Authors: E.M. Silini, B. Dal Bello, L.L. Rosa, N. Campanini, C. Tinelli, G. D'Ambrosio, S. Rossi
Journal: Journal of Hepatology (2009)
Letter: Comparison between free thyroxine index and effective thyroxine ratio.
Authors: J V Jorgensen
Journal: BMJ (1974)

correct period.The skewness of the distribu- tion suggests a bias towards slower rather than more rapid rates.Surprisingly perhaps this bias seems less evident when the solutions contained additives, though in this subgroup the proportion of correctly administered solutions was higher.It seems likely that the methods used in our survey will underestimate the true extent and size of variations in rate.Because we measured only the mean infusion rate shortterm decreases or increases would be missed.Attempts to correct these variations are commonly encountered in the ward as efforts to "get the bottle through in time" or to "slow it down a bit until we have someone free to change it."We look forward to hearing about the servo-controlled regulating clamp mentioned by Drs.Flack and Whyte, which will take a little of the uncertainty out of intravenous infusion therapy.-Weare, etc.,