tbuckley/cabot-search huggingface dataset:
Single or Double Segments of the Lung Occupying a Hemithorax
Authors: Richard H. Overholt, Edward A. Gaensler, James A. Bougas
Journal: New England Journal of Medicine (1959)

DISEASE may destroy all but one or two segments of a lung. Often, surgery is imperative, with a choice between pneumonectomy and conservation of the single or double segment. If there is disease on the opposite side, preservation of functioning lung tissue becomes especially important. Although lobectomy combined with segmental resection theoretically provides maximal preservation of function, it may present more formidable technical problems and postoperative hazards than pneumonectomy. Such added effort and risk can be justified only if it can be shown that the one or two residual segments contribute significantly toward the pulmonary economy.Because no data are . . .
Metabolism and mutagenicity of halogenated olefins--a comparison of structure and activity.
Authors: D Henschler
Journal: Environmental Health Perspectives (1977)

Chlorinated ethylenes are metabolized in mammals, as a first step, to epoxides. The fate of these electrophilic intermediates may be reaction with nucleophiles (alkylation), hydrolysis, or intramolecular rearrangement. The latter reaction has been studied in the whole series of chlorinated epoxiethanes. The rearrangement products found were: acyl chlorides (tetrachloro-, trichloro-, and 1,1-dichloroethylenes), or chlorinated aldehydes (1,2-dichloroethylenes, cis- and trans-, vinyl chloride). The metabolities found in vivo are identical with, or further derivatives of these rearrangment products, with one important exception: trichloroethylene. With this compound, in vivo rearrangement yields chloral exclusively. The mechanism of the different rearrangement has been identified as a Lewis acid catalysis. All chlorinated ethylenes have been investigated in a tissue-mediated mutagenicity testing system. The prominent molecular feature of those with mutagenic effects (trichloro-, 1,1-dichloro-, and monochloroethylene) is unsymmetric chlorine substitution which renders the epoxides unstable, whereas symmetric substitution confers relative stability and nonmutagenic property.
Dr Lansley's Monster
Authors: T. Delamothe, F. Godlee
Journal: BMJ (2011)

Too soon to let it out of the lab

What do you call a government that embarks on the biggest upheaval of the NHS in its 63 year history, at breakneck speed, while simultaneously trying to make unprecedented financial savings? The politically correct answer has got to be: mad.

The scale of ambition should ring alarm bells. Sir David Nicholson, the NHS chief executive, has described the proposals as the biggest change management programme in the world—the only one so large “that you can actually see it from space.” (More ominously, he added that one of the lessons of change management is that “most big change management systems fail.”1) Of the annual 4% efficiency savings expected of the NHS over the next four years, the Commons health select committee said, “The scale of this is without precedent in NHS history; and there is no known example of such a feat being achieved by any other healthcare system in the world.”2 To pull off either of these challenges would therefore be breathtaking; to believe that you could manage both of them at once is deluded⇓.



Universal Pictures Company

Like all the other structural reorganisations of the NHS, this one aims to improve health outcomes. What’s lacking is any coherent account of how these particular reforms will produce the desired effects, a point only underlined by the prime minister’s attempts to justify the reforms earlier this week.3

This latest top down reorganisation has been whipped up in an awful hurry. It went unmentioned in the political manifestos of the coalition parties before the last general election, was specifically excluded in pledges given before and after the election, and didn’t make it into the Coalition Agreement of 20 May 2010. Yet less than eight weeks later, its outline emerged in the …
Minor Psychiatric Disorders and Syncope: The Role of Psychopathology in the Expression of Vasovagal Reflex
Authors: Dionyssios Leftheriotis, Ioannis Michopoulos, Panayota Flevari, Athanassios Douzenis, Christoforos Koborozos, Anna Kostopoulou, George N. Theodorakis, Lefteris Lykouras, Dimitrios T. Kremastinos
Journal: Psychotherapy and Psychosomatics (2008)

&lt;i&gt;Background:&lt;/i&gt; A high prevalence of minor psychiatric disorders (MPDs) has been reported in patients with vasovagal syncope (VVS). However, the relationship between the psychiatric substrate and syncope remains unclear. &lt;i&gt;Methods:&lt;/i&gt; In order to test the hypothesis that MPDs may predispose to VVS, we assessed the prevalence of syncope, the response to head-up tilt test (HUTT) and the efficacy of psychiatric drug treatment in reducing syncopal episodes, in patients with recently diagnosed MPDs. The response to HUTT was compared with that in an equal number of matched (a) patients with VVS and (b) healthy controls. &lt;i&gt;Results:&lt;/i&gt; A high rate of patients with MPDs (58%) had a positive HUTT. Additionally, 45% had a history of syncope; among them, the rate of positive HUTT was identical to that in the VVS group (83%). Following psychiatric drug treatment, the number of patients with syncope decreased in the MPD group (6/67 from 30/67, p &lt; 0.01). Psychiatric symptoms and quality of life were also improved. The number of syncopal spells decreased equally in the MPD and VVS groups (0.6 ± 0.5 from 2.5 ± 1.4, p &lt; 0.01, and 0.7 ± 0.5 from 2.7 ± 1.3, p &lt; 0.01, respectively). &lt;i&gt;Conclusion:&lt;/i&gt; A high proportion of patients with MPDs experience syncope, associated with a high rate of positive HUTT, comparable to that observed in VVS. Psychiatric treatment results in the improvement of syncopal and psychiatric symptoms. These findings suggest involvement of co-occurring MPDs in the pathogenesis of VVS. Therefore, the diagnosis and treatment of MPDs, when present, may be crucial for the effective therapy of vasovagal syndrome.
INTER-COMPLICATIONS OF NEURASTHENIA.
Authors: JAMES G. KIERNAN
Journal: JAMA (1897)

Neurasthenia is an old term applied to a long recognized condition whose relations however have only been cleared of obscurity of late years. The older clinicians described it under the term "nervous adynamia," a peculiar condition of the entire organism most obviously improved and benefited by tonics. The nervous system is the first part visibly affected, the heart the second; the contractile heart fails not from want of blood as in anemia, but more directly as from a shock or some toxic influence. The capillary activity seems impaired, the metabolism and nutrition thereby declined, the contractile power of the heart and blood pressure being much diminished. This condition, which is essentially one of exhaustion, finally fixes itself, whatever be the primary cause, on the central nervous system and finds expression in a nervous instability taking the line of least resistance. It has been claimed that the condition is essentially one
Influence of human immunodeficiency virus infection on chronic hepatitis B in homosexual men
Authors: Jean-François Colin, Dominique Cazals-Hatem, Marie Anne Loriot, Michèle Martinot-Peignoux, Bach Nga Pham, Anne Auperin, Claude Degott, Jean-Pierre Benhamou, Serge Erlinger, Dominique Valla, Patrick Marcellin
Journal: Hepatology (1999)

The aim of this study was to assess the influence of human immunodeficiency virus (HIV) infection on chronic hepatitis B. In a series of 132 (65 anti–HIV positive) homosexual non-drug addicted men with chronic hepatitis B, the liver function was assessed with biochemical tests; the degree of hepatitis B virus (HBV) replication was assessed with serum HBV DNA level and with immunoperoxidase staining of hepatitis B core (HBc) antigen on liver specimens; and the severity of liver lesions was assessed with an histology activity index. Anti–HIV-positive and anti–HIV-negative patients were not different for serum aspartate transaminase activity, bilirubin, prothrombin, and histology activity index. Anti–HIV-positive patients had lower serum alanine transaminase activity levels ( P = .0001), lower serum albumin levels ( P = .0009), and higher serum HBV DNA levels ( P = .01). There was a higher prevalence of cirrhosis in anti–HIV-positive patients ( P = .04). In homosexual men with chronic hepatitis B, HIV infection is associated with a higher level of HBV replication and a higher risk for cirrhosis without increased liver necrotico–inflammatory process.
Association between the Clinical Presentation and Epidemiological Features of Familial Prostate Cancer in Patients Selected for Radical Prostatectomy
Authors: T. Paiss, K. Herkommer, B. Bock, H. Heinz, W. Vogel, Martina Kron, R. Kuefer, R.E. Hautmann, J.E. Gschwend
Journal: European Urology (2003)
PTU-262 Alcohol-misuse and inpatient detoxification: the increasing workload and impact of an alcohol care team and alcohol specialist nurse (ASN) in a district general hospital
Authors: V L Beckett, J Ching, V Wood, G Singh
Journal: Gut (2012)

<h3>Introduction</h3> The prevalence of alcohol misuse has risen dramatically over the past decade with younger individuals (aged 16–44 years) and women increasingly affected.<sup>1</sup> In 2007 24% adults were classified as hazardous drinkers (33% men, 16% women).<sup>2</sup> Over a 15-year period hospital admission rates for alcohol-related disorders have doubled,<sup>3</sup> with significant social and economic consequences. Recently, The British Society of Gastroenterology and NICE recommended an Alcohol Care Team including an ASN in every District General Hospitals to ensure early and effective inpatient treatment of patients with alcohol misuse; maximising compliance and reducing relapse. Studies indicate that an ASN generates 400 fewer admissions per year with shorter durations of stay and lower mortality rates.<sup>4</sup> <h3>Methods</h3> We retrospectively audited the impact of the ASN on rates of inpatient referrals and medical detoxification regimes undertaken between 2004 and 2011 at Bassetlaw District General Hospital. Rates of commenced and completed detoxifications in addition to self-discharge data were obtained. Medical and surgical inpatients were included. Exclusion criteria: outpatient and A&amp;E attendances, telephone referrals. <h3>Results</h3> Between 2004 and 2011 the number of inpatient referrals for medical detoxification increased BY 657% (49–371 referrals per year). On average, the majority of inpatients were male (66%) and 48 years of age (range 17–90 years). Over a 7-year period the number of inpatient detoxifications commenced increased by 600% (24–168 detoxifications per year). Similarly, completed detoxifications increased by 517% (23 and 142 completed detoxifications in 2004 and 2011 respectively). On average 90.8% (714/786) detoxifications were completed prior to discharge. 9.2% (72/786) patients self-discharged prior to completing the detoxification regime. <h3>Conclusion</h3> The workload of the Alcohol Care Team and ASN has increased substantially over a 7-year period, reflecting the rising prevalence of alcohol misuse and alcohol-related disease. The ASN provides early recognition and implementation of medical detoxification regimes for inpatients, offering support and continuity of care to maximise compliance and efficacy of treatment. Greater recognition and investment in alcohol services is essential within all UK District General Hospitals to minimise the growing burden of alcohol misuse. <h3>Competing interests</h3> None declared. <h3>References</h3> 1. <b>BMA Board of Science</b>. Alcohol Misuse: Tackling the UK Epidemic. 2008. 2. <b>NHS Information Centre</b>. <i>Statistics on Alcohol</i>. 2010. 3. <b>Institute of Alcohol Studies</b>. <i>The Impact of Alcohol on the NHS</i>. 2009. 4. <b>NHS Evidence</b>. Alcohol Care Teams: To Reduce Acute Hospital Admissions and Improve Quality of Care. 2011.
Intrahepatic Lesions Demonstrated to be Hemangiomas after a Ten-Year Lapse
Authors: MOHAMED A. ANTAR, JOAN M. MACK, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1989)

A 48-year-old man had multiple Intrahepatic lesions on both CT and liver scans. However, they were relatively unchanged from those detected 10 years previously. Blood pool imaging demonstrated that they were hemangiomas.
ABO-Incompatible Heart Transplantation in Infants
Authors: Lori J. West, Stacey M. Pollock-Barziv, Anne I. Dipchand, K. Jin Lee, Carl J. Cardella, Leland N. Benson, Ivan M. Rebeyka, John G. Coles
Journal: New England Journal of Medicine (2001)

Transplantation of hearts from ABO-incompatible donors is contraindicated because of the risk of hyperacute rejection mediated by preformed antibodies in the recipient to blood-group antigens of the donor. This contraindication may not apply to newborn infants, who do not yet produce antibodies to T-cell–independent antigens, including the major blood-group antigens.
Patterns of individual differences and rational choice
Authors: Vittorio Girotto
Journal: Behavioral and Brain Sciences (2000)

I discuss an aspect of individual differences which has not been considered adequately in the target article, despite its potential role in the rationality debate. Besides having different intellectual abilities, different individuals may produce different erroneous responses to the same problem. In deductive reasoning, different response patterns contradict deterministic views of deductive inferences. In decision-making, variations in nonoptimal choice may explain successful collective actions.
Functional similarities of asbestosis and cryptogenic fibrosing alveolitis.
Authors: J Markos, A W Musk, K E Finucane
Journal: Thorax (1988)

The pathological features in the lung in asbestosis and cryptogenic fibrosing alveolitis are similar. Patients with asbestosis, however, appear to have less severe impairment of transfer factor (TLCO) than those with fibrosing alveolitis for a given level of radiographic abnormality when assessed on the basis of the International Labour Organisation (ILO) profusion score. The impairment of lung function in the two disorders has been compared in more detail in 29 patients with asbestosis and 25 with fibrosing alveolitis, arterial oxygen desaturation during exercise being used to define the severity of the disorders. Arterial oxygen saturation (ear oximeter) and oxygen uptake were measured during incremental exercise on a cycle ergometer. TLCO (single breath technique) and total lung capacity (TLC, plethysmograph) were measured. Chest radiographs were graded for profusion according to the ILO international classification. Patients with asbestosis had significantly higher mean values for TLCO and TLC and lower mean profusion scores than those with fibrosing alveolitis. When stratified for the degree of arterial oxygen desaturation, however, no significant differences were found in TLCO, TLC, or profusion score between the two disorders. To the extent that arterial oxygen desaturation with exercise reflects the morphological severity of the disease, these results suggest that, for a given degree of interstitial lung disease, asbestosis and cryptogenic fibrosing alveolitis are functionally and radiologically similar.
Problems with computerising patients' records are "as serious as ever," say MPs
Authors: M. Cross
Journal: BMJ (2009)

Pressure on the NHS in England to abandon or radically reform its £13bn (€14bn; $18bn) scheme to computerise all patients’ records reached a new peak this week with the publication of a critical parliamentary report. The Committee of Public Accounts’ second investigation into the NHS national programme for IT says that the health service may never adopt the programme’s core systems for acute hospitals but will end up paying for them anyway.

Although the 7 year old programme has notched up some achievements, risks remain “as serious as ever,” said the committee’s chairman, the Conservative MP Edward Leigh. The committee’s report says that the main point of concern is the installation of electronic records in secondary care. Originally the …
Degenerative aortic stenosis
Authors: Radhakrishnan Ramaraj, Vincent L Sorrell
Journal: BMJ (2008)

#### Summary points 

Aortic stenosis is the most common valvular lesion in Europe and North America. It primarily presents as calcific aortic stenosis in 2-7% of the population aged >65 years.1 About 80% of adult patients with symptomatic aortic stenosis are male. As 1-2% of the population is born with a congenital bicuspid aortic valve and populations are ageing, aortic stenosis is becoming more common. By 2020, about 3.5 million people in England are expected to have aortic sclerosis and 150 000 will have severe aortic stenosis.2 Here we provide an overview to help diagnosis and a summary of the management of AS and its sequelae. Many of the points made in this review are based on randomised controlled trials. However, observational studies and the guideline recommendations of the American Heart Association and the American College of Cardiology and of the European Society of Cardiology are also included to provide comprehensive overviews that are beyond the scope of this article.

The most common cause of aortic stenosis in adults is calcification of a normal trileaflet (fig 1⇓). Calcific aortic stenosis is thought to be a degenerative process that shares many features with coronary artery disease, such as lipid accumulation, …
Communicability in Consultation/Liaison Psychiatry: Patient Treatment and Patient Care
Authors: Grethe Rasmussen, Truls-Eirik Mogstad
Journal: Psychotherapy and Psychosomatics (1983)

Effective communication seems to necessitate a very conscious (supra-) professional attitude at the hand of the liaison person, so that she or he continuously keeps in mind the possibilities and limitations in terms of communicability – no matter rank or level of consumers. From the point of view of communicability in general, one will need: (a) a body of knowledge and techniques relevant to the needs and purposes of the consumers; (b) a varied set of understandable languages in terms of frames of reference and definitions of concepts, adjusted to the various levels of complexity needed, (c) liaison person attitudes coherent to the chosen frames of reference, (d) a realistic view of the possibilities in different liaison set-ups, and (e) a conscious didactic strategy based on considerations of the aims of one's function. Among the above listed factors we shall especially focus on our 'erroneous zones' and failures in our endeavors to forward psychosomatic ideas and attitudes, and some implications of patient care and nursing concretely in connection with some cases submitted to minor surgical treatment, demonstrating the importance of practical psychosomatic impact at the level of patient nursing and care.
Methadone, Commonly Used as Maintenance Medication for Outpatient Treatment of Opioid Dependence, Kills Leukemia Cells and Overcomes Chemoresistance
Authors: Claudia Friesen, Mareike Roscher, Andreas Alt, Erich Miltner
Journal: Cancer Research (2008)

Abstract The therapeutic opioid drug methadone (d,l-methadone hydrochloride) is the most commonly used maintenance medication for outpatient treatment of opioid dependence. In our study, we found that methadone is also a potent inducer of cell death in leukemia cells and we clarified the unknown mechanism of methadone-induced cell killing in leukemia cells. Methadone inhibited proliferation in leukemia cells and induced cell death through apoptosis induction and activated apoptosis pathways through the activation of caspase-9 and caspase-3, down-regulation of Bcl-xL and X chromosome–linked inhibitor of apoptosis, and cleavage of poly(ADP-ribose) polymerase. In addition, methadone induced cell death not only in anticancer drug–sensitive and apoptosis-sensitive leukemia cells but also in doxorubicin-resistant, multidrug-resistant, and apoptosis-resistant leukemia cells, which anticancer drugs commonly used in conventional therapies of leukemias failed to kill. Depending on caspase activation, methadone overcomes doxorubicin resistance, multidrug resistance, and apoptosis resistance in leukemia cells through activation of mitochondria. In contrast to leukemia cells, nonleukemic peripheral blood lymphocytes survived after methadone treatment. These findings show that methadone kills leukemia cells and breaks chemoresistance and apoptosis resistance. Our results suggest that methadone is a promising therapeutic approach not only for patients with opioid dependence but also for patients with leukemias and provide the foundation for new strategies using methadone as an additional anticancer drug in leukemia therapy, especially when conventional therapies are less effective. [Cancer Res 2008;68(15):6059–64]
Interior of the Palmhouse on the Pfaueninsel Near Potsdam
Authors: M. Therese Southgate
Journal: JAMA (2006)

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