tbuckley/cabot-search huggingface dataset:
E-booking system for endoscopy training lists enhances their utilisation
Authors: N. A. F. Walker, A. McNair, A. Beale, R. Greenwood, J. M. Blazeby
Journal: Gut (2011)

<h3>Introduction</h3> Provision of dedicated training lists is a key criterion of the Global Rating scale ('GRS') training domain for Joint Advisory Group on GI Endoscopy ('JAG'). Extra time within training lists allows endoscopy supervision but full utilisation of lists is necessary to avoid wastage. Changes in trainees9 work patterns makes regular attendance at training lists difficult. The aim of this study was to optimise the use of dedicated endoscopy training lists with an electronic booking system. Prior to the new system, trainees attended lists haphazardly. With the new system, trainees booked training lists on line in advance for a suitable time. <h3>Methods</h3> Attendance was confirmed by the endoscopy reporting system and validated by comparing two trainees9 logbooks. Medical and surgical endoscopy training lists were audited in 2007/08 for 24 months, and in 2010 for 4 months following introduction of the booking system. Utilisation was calculated as the number of 'points' used by trainees divided by the total points available for the training lists. (Training lists have 16 'points' and non training (service lists) have up to 24 points. Gastroscopy and flexible sigmoidoscopy have 2 points, colonoscopy 4 points, upper GI EUS 5 points and an ERCP 6 points.) <h3>Results</h3> In 2007/08, 12 trainees performed 677 procedures, equivalent to 1858 points, with 874 points (47.0%) on training lists and 984 (53.0%) on non-training lists. Training lists were 874/4928 (17.7%) utilised (95% CI 16.6%&gt;18.8%). In 2010, 10 trainees performed 276 procedures (766 points) in the 4 months after introduction of the electronic booking system. 498 points (65.0%) were on training and 268 (35.0%) were on non-training lists. The lists were 498/816 (61.0%) utilised in 2010 (95% CI 57.6%&gt; 64.4%). The most significant improvements in utilisation were seen in upper GI and medical training lists, which increased from 32/1616 (2.0%) and 180/1632 (11.0%) in 2007/08 to 132/272 (48.5%) and 248/272 (91.2%) in 2010. <h3>Conclusion</h3> The electronic booking system improved attendance at dedicated training lists from 17.7% in 2007/08 to 61.0% in 2010. The system also improved the proportion of training done on allocated training lists rather than service lists from 47.0% in 2007/08 to 65.0% in 2010. The most significant improvements were seen in medical and upper GI lists. Such booking systems can help trainees to obtain competencies within shift systems and reduce pressure on endoscopy services.
The Law, Public Policy, and the Peddlers of Tobacco
Authors: Owen S. Surman
Journal: JAMA (1992)

To the Editor.  —A sign in the window of a local pharmacy reads, Mail order prescriptions may be hazardous to your health. The same store displays attractively packaged cigarettes next to the lottery machine by the cash register.  I remember the good-natured druggist who sold milkshakes, medicines, and other essentials when I was a boy growing up in one of Boston's ethnic neighborhoods. The proprietor wore a white coat, a mustache, and a warm smile that won my confidence.  In light of current knowledge, I find it unacceptable that the corner pharmacy and food stores sell tobacco products in a setting ostensibly designed to ensure public safety.  is not a medicine or a food. Its sale should be properly restricted to tobacconist shops.  In Tobacco Liability and Public Health Policy Gostin et al 1 comment that health warnings on cigarette packaging are countermanded through advertising, as well as social
Insulin Resistance and Atherosclerosis
Authors: Julie Nigro, Narin Osman, Anthony M. Dart, Peter J. Little
Journal: Endocrine Reviews (2006)

The epidemic of obesity in the developed world over the last two decades is driving a large increase in type 2 diabetes and consequentially setting the scene for an impending wave of cardiovascular morbidity and mortality. It is only now being recognized that the major antecedent of type 2 diabetes, insulin resistance with its attendant syndrome, is the major underlying cause of the susceptibility to type 2 diabetes and cardiovascular disease. In metabolic tissues, insulin signaling via the phosphatidylinositol-3-kinase pathway leads to glucose uptake so that in insulin resistance a state of hyperglycemia occurs; other factors such as dyslipidemia and hypertension also arise. In cardiovascular tissues there are two pathways of insulin receptor signaling, one that is predominant in metabolic tissues (mediated by phosphatidylinositol-3-kinase) and another being a growth factor-like pathway (mediated by MAPK); the down-regulation of the former and continued activity of the latter pathway leads to atherosclerosis. This review addresses the metabolic consequences of the insulin resistance syndrome, its relationship with atherosclerosis, and the impact of insulin resistance on processes of atherosclerosis including insulin signaling in cells of the vasculature.
Vasopressin Analogue DDAVP in Diabetes Insipidus: Clinical and Laboratory Studies
Authors: C. R. W. Edwards, M. J. Kitau, T. Chard, G. M. Besser
Journal: BMJ (1973)

In seven patients with cranial diabetes insipidus an analogue of vasopressin, DDAVP, produced an antidiuresis lasting up to 20 hours after a single intranasal dose. Lysine vasopressin (LVP) in the same dose produced a less potent antidiuresis which lasted for only three to four hours. The plasma half life of DDAVP was 7·8 and 75·5 min for the fast and slow phases, compared with 2·5 and 14·5 min for LVP. Radioiodine-labelled DDAVP was not destroyed by incubation with late pregnancy plasma, which contains an enzyme that inactivates vasopressin. The slow metabolic clearance of DDAVP, its absorption through the nasal mucosa, and its lack of side effects make this the ideal drug for the treatment of vasopressin-sensitive diabetes insipidus. Patients usually require 10 to 20 μg DDAVP given intranasally twice daily for good clinical control of their diabetes insipidus.
Nitric oxide controls cardiac substrate utilization in the conscious dog
Authors: F Recchia
Journal: Cardiovascular Research (1999)

Objectives: The aim of this study was to determine whether the acute inhibition of nitric oxide (NO) synthase causes changes in cardiac substrate utilization which can be reversed by a NO donor. Methods: NO synthase was blocked by giving 30 mg/kg of nitro-l-arginine (NLA) i.v. to 15 chronically instrumented dogs. Hemodynamics and blood samples from aorta and coronary sinus were taken at control and at 1 and 2 h after NLA. In five dogs, 0.4 mg/kg of the NO donor 3754 was given i.v. 1 h after NLA. In six dogs, angiotensin II was infused over 2 h (20–40 ng/kg/min) to mimic the hemodynamic effects of NLA. Results: Two h after NLA: mean arterial pressure was 153±4 mmHg; MVO2 increased by 38%; cardiac uptake of lactate and glucose increased, respectively, from 20.0±5.0 to 41.0±9.3 μmol/min and from 1.1±0.7 to 6.8±1.5 mg/min (all P<0.05 vs. control). Cardiac uptake of free fatty acids decreased by 43% after 1 h (P<0.05) and returned to control values at 2 h. Cardiac respiratory quotient increased from 0.76±0.03 to 1.05±0.07, indicating a shift to carbohydrate oxidation. All these changes were reversed by the NO donor. In the dogs receiving angiotensin II infusion, MVO2 increased by 28% and lactate uptake doubled (both P<0.05), but no other metabolic changes where observed. Conclusions: The acute inhibition of NO synthase by NLA causes a switch from fatty acids to lactate and glucose utilization by the heart which can be reversed by a NO donor, suggesting an important regulatory action of NO on cardiac metabolism.
Plague, rats and the Bible again
Authors: J. P Griffin
Journal: Journal of the Royal Society of Medicine (2006)

The editorial 'Too little quality; too many doctors' (June 2006 JRSM 1 ) is incorrect to suggest that the General Medical Council (GMC) had a 'sudden demand for overseas graduates to have a work permit'.The GMC does not have any visa requirements for international medical graduates (IMGs).The Home Office is responsible for setting visa requirements.International medical graduates are responsible for ensuring that they have the appropriate visa when they enter the UK.
Iatrogenic Psychotic Depressive Reaction in Hypertensive Patients
Authors: WADE H. LEWIS
Journal: American Journal of Psychiatry (1971)

The author describes the progress of psychotic depression in hypertensive patients whose medication has produced hyponatremia and low sodium levels. He cautions psychiatrists against prescribing drugs like imipramine, since these may make the patient increase his fluid intake, decreasing his electrolyte and sodium levels and producing severe physical and mental reactions.
MATRIX METALLOPROTEINASE-9 IS ASSOCIATED WITH THE SEVERITY AND MAJOR ADVERSE CARDIOVASCULAR EVENT IN PATIENTS WITH SYSTOLIC HEART FAILURE
Authors: Tetsuji Morishita, Hiroyasu Uzui, Kenichiro Arakawa, Naoki Amaya, Kenichi Kaseno, Kentaro Ishida, Takehiko Sato, Yoshitomo Fukuoka, Hiroyuki Ikeda, Etsuko Ikeda, Ako Fujii, Machiko Koike, Yusuke Sato, Kaori Hisazaki, Junya Yamaguchi, Jong-Dae Lee, Hiroshi Tada
Journal: Journal of the American College of Cardiology (2014)
Corticosteroids and Antibiotics for the Treatment of Fulminant Hydrocarbon Aspiration
Authors: Russell W. Steele
Journal: JAMA (1972)

Twenty mongrel dogs were used to examine the efficacy of corticosteroids and antibiotics for the treatment of hydrocarbon aspiration. The animals were randomly assigned to a control or treatment group and were given a median lethal dose of kerosene intratracheally. Treated animals received intramuscularly administered dexamethasone sodium phosphate and ampicillin sodium. There was no statistical difference between the control and treated animals for mortality; respiration and pulse rates; clinical appearance; arterial pH, oxygen pressure, and carbon dioxide pressure; complete blood cell count; serum electrolyte levels; roentgenograms of the chest; or gross and microscopic pulmonary pathologic findings. The results provide no evidence that currently recommended corticosteriods and antibiotics are efficacious in the treatment of fulminant cases of hydrocarbon aspiration.
Dr Alexis Carrel and Tissue Culture-Reply
Authors: Hassan Najafi
Journal: JAMA (1984)

In Reply.—  Many thanks for allowing me to read the very informative and pertinent letters sent by Drs Hayflick and Witkowski. It is quite evident from the content of the correspondence and their personal publications that they would have been infinitely better qualified to judge Dr Carrel's work on tissue culture than I was, when I received the invitation. I greatly regret the incomplete research of the literature, particularly those cited by Drs Hayflick and Witkowski and agree with the latter, that lack of reference to the biography by W. S. and P. D. Edwards was an unfortunate omission.  The distinguishedJournal of the American Medical Associationand its sophisticated readers would have been better served had the perspective on Carrel's tissue culture research been written by an expert equally knowledgeable and one that would have been devoid of nonscientific bias.  I confess that I have always regarded Dr Carrel
Diabetes-Related Utilization and Costs for Inpatient and Outpatient Services in the Veterans Administration
Authors: Matthew L. Maciejewski, Charles Maynard
Journal: Diabetes Care (2004)

-The purpose of this study was to calculate the total number of inpatient hospitalizations, outpatient clinic visits, and total direct health care costs associated with veterans with diabetes receiving care in Veterans Administration (VA) facilities. RESEARCH DESIGN AND METHODS-The number of inpatient hospitalizations is tracked for years 1994-1998, and outpatient clinic visits are tracked for years 1997 and 1998. Trends in utilization across different age and racial groups, as well as total direct inpatient and outpatient costs for 1998, are presented.-Between 1994 and 1998, hospitalization rates decreased from 1.68 to 1.61. The average number of outpatient visits was 4.5 in 1997 and 4.6 in 1998. VA incurred $214.8 million in outpatient expenditures and $1.45 billion in inpatient expenditures for veterans with diabetes receiving VA care.-Health care delivery systems and payors track the cost and utilization of services by specific patient groups to support disease management, quality improvement, external reporting, and cost containment. Tracking the utilization and cost of diabetes care is necessary to understand the financial impact of diabetes on health care systems and the overall burden of diabetes on individuals.
E-cadherin antagonizes transforming growth factor β1 gene induction in hepatic stellate cells by inhibiting RhoA-dependent Smad3 phosphorylation
Authors: Il Je Cho, Young Woo Kim, Chang Yeob Han, Eun Hyun Kim, Richard A. Anderson, Young Sok Lee, Chang Ho Lee, Se Jin Hwang, Sang Geon Kim
Journal: Hepatology (2010)

Cadherins mediate cell-cell adhesion and catenin (ctn)-related signaling pathways. Liver fibrosis is accompanied by the loss of E-cadherin (ECAD), which promotes the process of epithelial-mesenchymal transition. Currently, no information is available about the inhibitory role of ECAD in hepatic stellate cell activation. Because of ECAD's potential for inhibiting the induction of transforming growth factor β1 (TGFβ1), we investigated whether ECAD overexpression prevents TGFβ1 gene induction; we also examined what the molecular basis could be. Forced expression of ECAD decreased α-smooth muscle actin and vimentin levels and caused decreases in the constitutive and inducible expression of the TGFβ1 gene and its downstream genes. ECAD overexpression decreased Smad3 phosphorylation, weakly decreased Smad2 phosphorylation, and thus inhibited Smad reporter activity induced by either treatment with TGFβ1 or Smad3 overexpression. Overexpression of a dominant negative mutant of ras homolog gene family A (RhoA) diminished the ability of TGFβ1 to elicit its own gene induction. Consistently, transfection with a constitutively active mutant of RhoA reversed the inhibition of TGFβ1-inducible or Smad3-inducible reporter activity by ECAD. Studies using the mutant constructs of ECAD revealed that the p120-ctn binding domain of ECAD was responsible for TGFβ1 repression. Consistently, ECAD was capable of binding p120-ctn, which recruited RhoA; this prevented TGFβ1 from increasing RhoA-mediated Smad3 phosphorylation. In the liver samples of patients with mild or severe fibrosis, ECAD expression reciprocally correlated with the severity of fibrosis.Our results demonstrate that ECAD inhibits Smad3/2 phosphorylation by recruiting RhoA to p120-ctn at the p120-ctn binding domain, whereas the loss of ECAD due to cadherin switching promotes the up-regulation of TGFβ1 and its target genes, and facilitates liver fibrosis.
Pulmonary vein isolation for treatment of atrial fibrillation: impact of age on success and complications
Authors: Thomas Dresing, Nassir F. Marrouche, David O. Martin, Christopher Cole, Ahmad Abdul-Karim, Robert Schweikert, Eduardo Saad, Krzystof Balaban, Patrick Tchou, Walid Saliba, Andrea Natale
Journal: Journal of the American College of Cardiology (2002)
Effects of perinatal exposure to bisphenol A on play behavior of female and male juvenile rats.
Authors: Francesco Dessì-Fulgheri, Stefania Porrini, Francesca Farabollini
Journal: Environmental Health Perspectives (2002)

In higher vertebrates, estrogen can exert an organizational effect on sexually dimorphic areas of the central nervous system (CNS) during the perinatal phase of development. The possibility that estrogenic pollutants may mimic estrogen action on the CNS during development and produce long-lasting or irreversible effects is an issue of great concern. Bisphenol A (BPA), a compound widely used in the food industry and in dentistry, has proven estrogenic actions. To study its potential developmental effects on behavior, we gave female Sprague-Dawley rats 40 microg/kg/day BPA from conception to weaning postnatal day 21 and 400 microg/kg/day BPA from gestation day 14 to postnatal day 6. After exposure, we studied social behavior in a play situation in juvenile male and female offspring. The attempt to use play behavior to study the effects of BPA yielded some interesting results. We observed an early action of BPA on several behavioral categories in both males and females. In particular we observed a masculinization of female behavior in two behavioral categories (play with females and sociosexual exploration), an effect probably mediated by the estrogenic activity of BPA in the CNS. These long-lasting effects of BPA could have important consequences at individual and population levels.
Massive Secretion by T Cells Is Caused by HIV Nef in Infected Cells and by Nef Transfer to Bystander Cells
Authors: Claudia Muratori, Lucas E. Cavallin, Kirsten Krätzel, Antonella Tinari, Angelo De Milito, Stefano Fais, Paola D'Aloja, Maurizio Federico, Vincenzo Vullo, Alla Fomina, Enrique A. Mesri, Fabiana Superti, Andreas S. Baur
Journal: Cell Host & Microbe (2009)
The Goulstonian Lectures on Puerperal Fever
Authors: R. J. Lee
Journal: BMJ (1875)

MaR. PRESIDENT,-The disease generally known as puerperal distinguished by characters which render it peculiarly suitable ject for the consideration of such an audience as I have addressing on the present occasion.We can trace its history in the literature of medical less continuously from the present time to periods so we possess now only scanty records of them.In the progressive historical inquiry, we find that puerperal fever, though comparatively modern introduction into nosological classification, has of exactness in its nature which can be claimed by fewr +%vhich enables us to recogiiise it without difficulty in works of various authors.It has shared the same fate-or we ought to say, has enjoyed the same privilege-as those in that it has afforded the student of history the dletermining the character of mind, the method of investigation, of accuracy in observation, and the practical skill wlhiclh and exhibited at any particular point of time within torical records.Lastly, it may be regarded as the most recent and recipient of the favour and advantage which every branch our science and practice derives from the progress of physical knowledge.If puerperal fever be thus distinguished, it would to entertain you without fatigue in any one of the Iiiies which I have indicated.I am obliged, however, standard which I regard with deep respect, and with satisfaction, may be reduced to meet an unusual demand for caution in dealing with materials so abundantly afforded and
A proangiogenic peptide derived from vascular endothelial growth factor receptor-1 acts through α5β1 integrin
Authors: Simonetta Soro, Angela Orecchia, Lucia Morbidelli, Pedro Miguel Lacal, Veronica Morea, Kurt Ballmer-Hofer, Federica Ruffini, Marina Ziche, Stefania D'Atri, Giovanna Zambruno, Anna Tramontano, Cristina Maria Failla
Journal: Blood (2008)
Bile-duct Perforation in Infancy
Authors: G. Segni, C. Romano
Journal: BMJ (1965)

BRmTSHThe Kitagawa-Wright method,7 which was also tested by Begg et al., gave less precise results (±24 mg.) but was much easier to use.The taking and analysis of the breath sample was fully automatic, and the reading process was found to have an observer error of only a few mg., so it is reasonable to assume that the precision of the method would be the same wherever and by whoever it was used.Since 1963 (when the trials were carried out) the method has been substantially improved,5 and Professor Borkenstein,s the inventor of the Breathalyzer, has recently reported very close agreement between the two instruments.It therefore seems that it would now be possible to obtain by direct analysis of one breath as accurate an estimate of the bloodalcohol level as can be obtained by direct blood analysis.Since in practice at least two samples should be taken the estimate would be sub- stantially more accurate, and the advantages to all concerned of being able to get an immediate and definitive determination of the blood-alcohol level at the time of arrest would seem to be obvious.-Iam, etc.,
Abdominal Aortic Aneurysm as an Incidental Finding
Authors: Peter H. Lin, Alan B. Lumsden
Journal: New England Journal of Medicine (2003)

A 56-year-old man was involved in a minor bicycle accident in which the handlebars of the bicycle struck his abdomen. He came to the emergency room with swelling and pain in his anterior abdomen. He had a history of atrial fibrillation, which required oral anticoagulant therapy. Physical examination revealed fullness and mild tenderness in his right periumbilical region, with a large pulsatile abdominal mass. A computed tomographic scan of the abdomen revealed a right-sided hematoma of the rectus sheath, 8 cm by 6 cm (small arrow), with the incidental finding of an infrarenal abdominal aortic aneurysm, 7 cm in diameter . . .
An improved method for the isolation of fungi in onychomycosis
Authors: MARY P. ENGLISH, R. ATKINSON
Journal: British Journal of Dermatology (1973)

A description is given of the use of a drill for obtaining nail samples for fungal culture in cases of onychomycosis. The nail dust produced by the drill is collected by suction into a bag, and used to inoculate culture plates. Nail dust was found to be greatly superior to clippings for the successful culture of both dermatophytes and non‐dermatophytes. Possible reasons for this are discussed and it is suggested that in dermatological practice a drill should be used for sampling nails where attempts to culture from clippings have failed.
French antiviral drug is ruled ineffective
Authors: A Dorozynski
Journal: BMJ (1994)

French health authorities have declared ineffective an antiviral drug that has been prescribed to hundreds of patients with AIDS over the past six years. The drug, PB-100, was designed by a former researcher at the Pasteur Institute, Mirko Beljanski, and has become increasingly popular with doctors and patients, although its prescription and marketing have never been authorised. A number of patients are still receiving it, and it is far from certain that the so called “Beljanski affair” is over.

Beljanski, a doctor of biology, joined the Pasteur Institute in 1948, when he was 25, to work under Professor Pierre Lepine, who developed the French polio vaccine. Later he moved to the molecular biology department …
577 HEPATOCELLULAR CARCINOMA IN BUDD-CHIARI SYNDROME: A SINGLE CENTER EXPERIENCE IN KOREA
Authors: H.N. Park, J.Y. Yoon, K.H. Park, J.M. Lee, S.U. Kim, J.Y. Park, D.Y. Kim, S.H. Ahn, K.-H. Han, C.Y. Chon, Y.M. Moon
Journal: Journal of Hepatology (2010)