tbuckley/cabot-search huggingface dataset:
Sustained Virologic Response and Clinical Outcomes in Patients with Chronic Hepatitis C and Advanced Fibrosis
Authors: Bart J. Veldt, E. Jenny Heathcote, Heiner Wedemeyer, Juerg Reichen, W. Peter Hofmann, Stefan Zeuzem, Michael P. Manns, Bettina E. Hansen, Solko W. Schalm, Harry L.A. Janssen
Journal: Annals of Internal Medicine (2007)

Background: Clinical outcomes of chronic hepatitis C infection in patients with advanced fibrosis include liver failure, hepatocellular carcinoma, and death. Objective: To investigate whether sustained virologic response to treatment for hepatitis C is associated with improved clinical outcomes. Design: Retrospective cohort study. Setting: 5 hepatology units of tertiary care centers in Europe and Canada caring for patients with chronic hepatitis C treated between 1990 and 2003. Patients: Consecutively treated patients with chronic hepatitis C who had biopsy-proven advanced fibrosis or cirrhosis (Ishak score, 4 to 6). Measurements: Sustained virologic response, defined as absence of detectable hepatitis C virus RNA at 24 weeks after the end of treatment, and clinical outcomes, defined as death (liver-related or non–liver-related), liver failure, and hepatocellular carcinoma. Results: Of 479 patients, 29.6% had sustained virologic response and 70.3% did not. Median follow-up was 2.1 years (interquartile range, 0.8 to 4.9 years). Four patients with and 83 without sustained virologic response had at least 1 outcome event. Sustained virologic response was associated with a statistically significant reduction in the hazard of events (adjusted hazard ratio, 0.21 [95% CI, 0.07 to 0.58]; P = 0.003). The effect was largely attributable to a reduction in liver failure, which developed in no patients with and 42 patients without sustained virologic response (5-year occurrence, 0% vs. 13.3% [CI, 8.4% to 18.2%]; unadjusted hazard ratio, 0.03 [CI, 0.00 to 0.91]). Limitations: Because few events occurred in the sustained virologic response group, the study had limited ability to detect differences between groups in individual outcomes. In addition, the study was retrospective; selection and survival biases may therefore influence estimates of effect. Conclusion: Sustained virologic response to treatment is associated with improved clinical outcomes, mainly prevention of liver failure, in patients with chronic hepatitis C and advanced fibrosis.
Care by parents in hospital.
Authors: N Webb, D Hull, R Madeley
Journal: BMJ (1985)

Although only a small number of infants who had previously received intensive care required admission to the paediatric ward, they represented about half the bed occupancy of infants under 1 year.Interestingly, although the paediatric ward served only the Cambridge Area Health Authority, babies admitted to the neonatal intensive care unit from the region accounted for about one third of the bed occupancy of those aged under 1 year.This study highlights the need for continued intensive nursing care for a few infants under 1 year after their discharge from a neonatal intensive care unit.This represents a considerable workload for a general ward, and as the survival rates of such infants continue to improve4 it is vital that these wards should be appropriately staffed and equipped.
The preregistration alternative
Authors: C Illingworth
Journal: BMJ (1994)

I was told that I was only “a clerking machine.” The comment was meant to reassure me that as a new junior house physician responsibility for patient care did not rest on my shoulders alone. Far from finding the comment reassuring I found it devaluing. It was an underestimation of the reality and highly ironical in the face of current General Medical Council recommendations on the educational content of the preregistration year.

After the euphoria of qualifying as a doctor, my first day as a house officer had brought me crashing down from cloud nine. I was the unfortunate house physician on take holding the crash bleep; but I was worried about where to run to if it went off. The introductory talk for new house officers came on the second day - a whole day too late. Some of the anxiety I had experienced would have dissipated if there had been a proper induction, including a tour of the hospital, before the job started.

Our formal medical education took the form of a series of weekly one hour seminars, which were of a good quality and relevant to managing several medical conditions seen daily on the wards. But effective education calls for more than quality tuition; it requires receptive and undistracted pupillage. This was impossible as we were continually being bleeped away …
The long road to the top
Authors: Pat Sidley
Journal: BMJ (2005)

A black South African doctor is taking over as presidentof the World Medical Association. Kgosi Letlape spoke to Pat Sidley about overcoming the odds to make it to the top 

Ophthalmologist Kgosi Letlape tells a tortuous tale to explain why he gained his specialist degree in Edinburgh as opposed to Johannesburg. The new president of the World Medical Association was well enough qualified academically to have gained the degree in his home country of South Africa.

But it was well known among black doctors at the time that the white medical establishment would often unfairly fail black candidates in order to favour white candidates. Despite excellent grades and the likelihood of passing well if all things had been equal, Letlape decided that getting his fellowship in Edinburgh and following it up with the local qualification would make it much harder for white examiners to fail him. So he took that slightly longer route to becoming South Africa's first black ophthalmologist. Notwithstanding this, white colleagues on the wards expressed their resentment at his presence, taking the job of white doctors who were “serving their country” in the army, brutally enforcing the apartheid regime.

Letlape's story is common among black South African doctors. Fellow medic Dr Saadiq Kariem, who is a public health specialist and chief operating officer of Groote Schuur Hospital in Cape Town, says that it takes “tremendous sacrifice” on the part of the whole family to see to it that an intellectually gifted son or daughter manages to survive both the …
Changes of hepatitis B virus (HBV) markers during prolonged recombinant interferon alpha-2A treatment of chronic HBV infection
Authors: I. Mora, J.C. Porres, J. Bartolomé, J.A. Quiroga, J. Gutiez, C. Hernández Guio, C. Bas, V. Carreño
Journal: Journal of Hepatology (1987)
Severe pre-eclampsia of early onset.
Authors: B N Walters, T T Lao, V A Smith, K Blau, M de Swiet
Journal: BMJ (1983)

simplistic interpretation to an obviously complex and difficult matter.The absence of randomisation (for which we cannot place blame on the investigators) has merely compounded the problem.In my opinion, whether or not stopping smoking after a coronary attack has a long term survival benefit is still an open question.The diffi- culties in this Irish study exemplify the complexity of the problem.
Tumour size as a prognostic factor after resection of lung carcinoma.
Authors: A S Soorae, R A Smith
Journal: Thorax (1977)

Two hundred and ninety-five patients who underwent resection for carcinoma of the lung are reviewed, with a particular view to size of tumour and survival rate. The carcinomas were divided into four groups by size. It was found that the larger the tumour the worse was the prognosis. The prognosis in large carcinomas could not be directly attributed to a preponderance of an unfavourable cell type, lymph node metastasis or mediastinal extension. Vascular dissemination at the time of operation is believed to be a major factor for the poor prognosis in this group of carcinomas. Radiotherapy before operation and early ligation of the pulmonary veins might improve the results of resection of large carcinomas.
Prehospital and Hospital Care
Authors: Julian Redhead, Patricia Ward, Nicola Batrick
Journal: New England Journal of Medicine (2005)

On the morning of July 7, doctors were mobilized from all over the city to report to work and put their hospitals' major incident plans into action. Drs. Julian Redhead, Patricia Ward, and Nicola Batrick describe the medical response at St. Mary's Hospital, Paddington.
Calcium-alginate beads for the oral delivery of transforming growth factor-β1 (TGF-β1): stabilization of TGF-β1 by the addition of polyacrylic acid within acid-treated beads
Authors: Russell J. Mumper, Allan S. Huffman, Pauli A. Puolakkainen, Lisa S. Bouchard, Wayne R. Gombotz
Journal: Journal of Controlled Release (1994)
Where next for China?: Rising inequalities in health and wealth are biggest challenge
Authors: Sonal Singh
Journal: BMJ (2006)

Where next for China?Rising inequalities in health and wealth are biggest challenge Editor-I write with reference to the editorial by Liu. 1 Life expectancy in China doubled from 35 to 71 years between 1949 and 2001. 2 China's human development index has been rising steadily, and it ranked 85th among countries with an index of 0.755 in 2003. 2According to China's human development report, the national Gini coefficient for income distribution rose to 0.45 in 2002 from 0.3 in 1982. 2 The average income of the highest income tenth is 11 times that of the lowest tenth? 2Disparities in health indicators between urban and rural areas are widening.Life expectancy is 75.2 years for urban residents and 69.6 for rural residents. 2The human development index is 0.816 in urban areas and 0.685 in rural areas.Rural infant mortality at 34% and maternal mortality at 61.9 per 100 000 births are nearly double that in urban areas (14% and 33.1/100 000, respectively).Rural areas have only 2.4 medical personnel per 1000 residents, compared with 5.2 per 1000 residents in urban areas.Regional disparities are widespread, with the western regions faring the worst.Life expectancy for rural residents is less than 65 in Tibet, Yunnan, and Guizhou.Maternal mortality is also highest in the western regions.Tibet ranked lowest in terms of life expectancy (65.81 years), literacy (47%), and human development index (0.562). 2 The region has the lowest number of doctors and hospital beds in China.Only 15% of the entire population of China can afford medical insurance. 2Only 2% of rural migrant workers currently have unemployment insurance. 2Coercive public health policies include forced abortions. 3hina's ambitious aim of building a society in which people are not rich but have adequate food, clothing, and basic necessities for a decent life 2 will require addressing these widening disparities, prioritising health opportunities for all, and acknowledging the inherent, instrumental and constructive 4 roles of freedom in achieving these goals.
THE ERGASTOPLASM
Authors: Jules M. Weiss
Journal: The Journal of Experimental Medicine (1953)

The fine structure of the ergastoplasm of the pancreatic exocrine cell of Swiss albino mice has been studied with the electron microscope. It was found that this material consists of sac-like structures, which may be called ergastoplasmic sacs, embedded in an amorphous granular ground substance, the cytoplasmic matrix. The membranous wall of the ergastoplasmic sac is a structure approximately 250 A wide. Except for its greater electron density and granular structure, the ergastoplasmic membrane is similar in appearance to the nuclear, plasma, and mitochondrial membranes. From data available in the literature, and from our own evidence, the conclusion can be drawn that the ergastoplasmic membrane contains ribonucleic acid. The mode of formation of the ergastoplasm and secretory granules was studied in animals which were first fasted and subsequently fed. It was found that ergastoplasm is formed within the cytoplasm, near the nuclear membrane, and possibly from the plasma membrane. The secretory granules were observed to arise by accumulation of materials within small ergastoplasmic sacs.
Climate change: not a threat but a promise
Authors: F. Godlee
Journal: BMJ (1996)

Global warming can no longer be dismissed as a catastrophe theory dreamt up by scaremongers. In the past few months two reports from internationally renowned organisations have offered grave warnings of the threat that climate change poses, within current lifetimes, to humans and ecosystems1 2; and last week, in the face of frantic lobbying from the fossil fuel industry, 134 nations, including the United States, agreed to work towards “quantified legally binding” cuts in emissions of the main greenhouse gas, carbon dioxide. What is surprising is how little these concerns have impinged on the media and on our daily lives.

Earlier this month, the Intergovernmental Panel on Climate Change (IPPC) confirmed previous reports that human activity has had a “discernible influence” on the earth's climate, and painted a grim picture of the future if nothing was done.1 At current rates of increase in the burning of fossil fuels, it will take only another 50-60 years for the levels of carbon dioxide in the atmosphere to reach double the levels present at the start of the industrial revolution. By …
Detection of early nephropathy in Mexican patients with type 2 diabetes mellitus
Authors: Alfonso M. Cueto-Manzano, Laura Cortes-Sanabria, H. Ramon Martinez-Ramirez, Enrique Rojas-Campos, Graciela Barragan, Gilberto Alfaro, Jorge Flores, Moises Anaya, Jose L. Canales-Munoz
Journal: Kidney International (2005)
Erratum; Hepatic Cirrhosis in a Patient with Total Situs In versus Unique Findings on Liver-Spleen Imaging
Authors: MATTHEW J. KUHN, FUKIAT ONGSENG, C RICHARD GOLDFARB
Journal: Clinical Nuclear Medicine (1987)

Liver-spleen imaging was performed during the evaluation of abnormal liver function tests in a 39-year-old chronic alcoholic man. Increased activity in the lungs and bones indicated colloid shift. Paradoxically, an expected increase in splenic activity in the left upper quadrant of the abdomen was missing, while intense uptake on the right seemed to exclude hepatic dysfunction. Attention to the pulmonary uptake revealed a right-sided cardiac silhouette. Closer scrutiny of the activity in the right upper quadrant showed that it was splenic in shape, and reevaluation of the left upper quadrant showed a faintly visualized liver that had been displaced medially by ascites. A subsequent chest radiograph and barium enema confirmed the diagnosis of situs inversus. When coupled with cirrhosis, situs inversus presents an interesting diagnostic challenge on liver-spleen imaging.
Decision Making in Anesthesiology
Authors: Peter Chodoff
Journal: JAMA (1971)

Thirty adult preanesthetic interviews were performed, ten with a cathoderay-type input device and 25 with a mark-sense form. An International Business Machines Corporation system 360 model 40 computer with disk files was used. Three representative decisions were calculated: recent upper respiratory tract infection (URI), chronic smoker, and clues to chronic obstructive lung disease. The system should (1) upgrade the level at which allied professional personnel can function, (2) enlarge the role of the outpatient clinic, (3) reduce the length of hospital stay, (4) improve the quality of medical care, (5) reduce hospital costs, (6) improve the utilization of hospital beds and operating rooms, and (7) provide a tool for epidemiologic investigation of problems relating to anesthesiology.
Endoscopic Resection of Early Rectal Carcinoid Tumor
Authors: T. Deist, C. Kalisch
Journal: Endoscopy (2004)

In a paper recently published in Endoscopy, Nagai et al. [1] report on eight endoscopic resections of early rectal carcinoid tumors using the cap aspiration method. It is reassuring that all of the tumors were resected completely, although recurrence rates are not given. The authors describe the cap aspiration method as being an extremely safe procedure, since no immediate or late complications such as perforations occurred. They are not aware of any cases of perforation having been reported in the literature.
UN tries to secure safe corridors for humanitarian aid in Pakistan
Authors: J. Zarocostas, P. Moszynski
Journal: BMJ (2009)

United Nations relief officials have called for international aid to help nearly one million displaced people and to help large numbers of civilians trapped in the escalating conflict between Pakistan’s armed forces and Taliban militants in the country’s north west.

“Circumstances in these areas are very, very difficult. Supplies of electricity have been cut, which means often water systems are not functioning,” said Martin Mogwanja, the UN’s acting coordinator for Pakistan.

“The monetary system is not functioning because the banks have been closed, and the food supply is very limited because there is no means of distribution with many road blocks in all directions.

“We’re also concerned that a major hospital near Mingora, the capital town of Swat district, has had to be closed, and the doctors have evacuated themselves due to insecurity,” the UN official told reporters in Geneva in a teleconference.

“This means that there’s very limited medical capacity in those areas to respond to urgent medical needs of those who may be wounded in the fighting.”

Mr Mogwanja said that the humanitarian community is considering the establishment of safe corridors in the region, but noted, “It is very difficult to make the necessary contacts and to obtain the necessary guarantees …
Clinical Management of Behavior Disorders in Children
Authors: Howard Hansen
Journal: JAMA (1967)

The new third edition attests to the wide usage this book has enjoyed among physicians concerned with the care of children. As in the earlier two editions, it provides extensive and comprehensive information on the recognition, etiology, and management in this complex field of behavior disorders in children. The reader finds the material concisely and succinctly presented in practical and understandable medical language. As in the previous editions this text is intended for those physicians, be they pediatrician, general practitioner, school physician, or other, who devote themselves principally to the care of children. It is not a textbook on child psychiatry per se. Nevertheless, child psychiatrists in training, in clinical practice, and in teaching will find it of considerable value in focusing the pediatric viewpoint and in facilitating a meaningful exchange and a workable language between the psychiatrist and other medical colleagues. The present revision incorporates and integrates many recent
Retrolental fibroplasia and mental handicap.
Authors: H G Kinnell
Journal: BMJ (1983)

munity Medicine, the Community Medicine Consultative Committee, the Department of Health and Social Security, and the BCG Vaccination Subcommittee of the Joint Tuberculosis Committee on Vaccination and Immunisation.It is important that all doctors who diagnose tuberculosis, both pulmonary and non- pulmonary, ensure that their cases are notified according to the public health regula- tions.We appreciate that doctors in many specialties encounter tuberculosis only occasionally, and it is particularly these cases which may miss being notified unless special care is taken.The value of this survey would undoubtedly be enhanced if all cases in 1983 are in fact notified.
A 60s doctor enters the 80s. An interview with George Flesh
Authors: G. Flesh
Journal: JAMA (1985)

<h3>JAMA:</h3> Weren't you considered something of a political radical during medical school in the late 60s and early 70s? <h3>Flesh:</h3> In those days,<i>radical</i>became a scare word implying sweeping change and destruction of established structures. In my opinion, a true radical is not committed to turning the world upside down; rather, he is committed to an open search for fundamental causes and disdains the superficial. I was politically active as a medical student at UCLA. For example, the relationship between the pharmaceutical industry and the medical profession disturbed me a great deal. There was a drug company that gave black leather bags to sophomore medical students all over the country as a promotional device. Some of us felt this was inappropriate. I organized about three fourths of the class and we sent the bags to the Food and Drug Administration with a letter criticizing such gifts. I also wrote
Future of historic paintings is uncertain after closure of hospital site
Authors: Michael Day
Journal: BMJ (2007)

The future of four huge oil paintings by the British symbolist painter Frederick Cayley Robinson is uncertain after a decision by University College London Hospitals NHS Trust to sell them through the auctioneers Christie's.

The paintings used to be in the entrance hall of the Middlesex Hospital, which merged with the former University College Hospital more than 20 years ago, but no place has been found for them in the new UCLH building, after the closure of the Middlesex site. 

Admirers of the paintings, called the Acts of Mercy murals, say that the trust has a duty to keep them in the public domain. 

The four works, each measuring more than six square metres, were installed in the hospital in 1919 as homage to its work during the first world …
Cardiotoxicity of human recombinant interleukin-2 in rats. A morphological study.
Authors: J Zhang, Z X Yu, S L Hilbert, M Yamaguchi, D P Chadwick, E H Herman, V J Ferrans
Journal: Circulation (1993)

BACKGROUND One of the side effects of interleukin 2 (IL-2) cancer immunotherapy in humans is the vascular leak syndrome, which is frequently associated with depression of myocardial function, myocarditis, and myocardial necrosis. METHODS AND RESULTS To investigate this cardiotoxicity, IL-2 (three doses of 5 x 10(5) Cetus units/day i.p.) was given to rats for 2, 3, or 5 days. Heart, lung, liver, spleen, and kidney tissues were studied by light and electron microscopy and with immunoperoxidase techniques. Cardiac changes consisted of focal lymphocytic and eosinophilic infiltration, myocyte vacuolization, myofibrillar loss, and necrosis. Ultrastructural alterations included swelling of endothelial cells, with dissociation of intercellular junctions, migration of lymphocytes into the interstitium, and interstitial hemorrhage and edema. Close contact between infiltrating lymphocytes, particularly large granular lymphocytes, and cardiac myocytes was often observed in areas of tissue damage. All lesions were more severe on day 5 than on days 2 and 3. Immunoperoxidase stains demonstrated asialo GM1 ganglioside antibody-positive, granular lymphocytes to be much more frequent in myocardium of IL-2-treated rats than in that of control rats. CONCLUSIONS Although we cannot exclude the possibility of a direct toxic effect of IL-2 on myocytes, our observations suggest that the myocardial damage produced by this agent is triggered by IL-2-activated lymphocytes that exert cytolytic effects, first on endothelial cells and then on cardiac myocytes, thus producing lesions that involve both the cardiac microcirculation and the muscle cells.
A comparative study of toxic erythema of pregnancy and herpes gestationis
Authors: R.C. HOLMES, M.M. BLACK, J. DANN, D.C.O. JAMES, B. BHOGAL
Journal: British Journal of Dermatology (1982)

SUMMARY We compared the clinical features, histopathology, immunopathology and immunogenetics of 30 patients with toxic erythema of pregnancy and 24 patients with herpes gestationis. Although we found some clinical and histopathological overlap we highlighted several important differences. In toxic erythema of pregnancy prominent striae were frequently present. Herpes gestationis was suggested by the occurrence of periumbilical lesions, acute exacerbations immediately after delivery, and persistence of the eruption for more than 3 weeks post-partum. In herpes gestationis, immunofluorescence studies were consistently positive, there was a high frequency of HLA-B8 and an association with autoimmune thyrotoxicosis. Toxic erythema of pregnancy did not share these immunological features. Therefore we feel that toxic erythema of pregnancy and herpes gestationis should continue to be classified as separate disorders.