tbuckley/cabot-search huggingface dataset:
ADHD affects 3% of adults over 60, Dutch study finds
Authors: S. Wedgwood
Journal: BMJ (2012)

A Dutch study looking at attention-deficit/hyperactivity disorder in older adults has found that the condition affects 3% of people over 60 years of age, meaning that there are about 95 000 people with the disorder in the Netherlands.1 

Aartjan Beekman, head of the department of psychiatry at VU University Medical Centre in Amsterdam and the study’s lead researcher, told the BMJ that the study showed that the disorder is not confined to young people and that clinical implications of …
Peer Review of the Quality of Care
Authors: Maureen A. Smith, Adam J. Atherly, Robert L. Kane, James T. Pacala
Journal: JAMA (1997)

Peer assessments have traditionally been used to judge the quality of care, but a major drawback has been poor interrater reliability.To compare the interrater reliability for outcome and process assessments in a population of frail older adults and to identify systematic sources of variability that contribute to poor reliability.Eight sites participating in a managed care program that integrates acute and long-term care for frail older adults.A total of 313 frail older adults.Retrospective review of the medical record with 180 charts randomly assigned to 2 geriatricians, 2 geriatric nurse practitioners, or 1 geriatrician and 1 geriatric nurse practitioner and 133 charts randomly assigned to either a geriatrician or a geriatric nurse practitioner.Interrater reliabilities for structured implicit judgments about process and outcomes for overall care and care for each of 8 tracer conditions (eg, arthritis).Outcome measures had higher interrater reliability than process measures. Five outcome measures achieved fair to good reliability (more than 0.40), while none of the process measures achieved reliabilities more than 0.40. Three factors contributed to poorer reliabilities for process measures: (1) an inability of reviewers to differentiate among cases with respect to the quality of management, (2) systematic bias from individual reviewers, and (3) systematic bias related to the professional training of the reviewer (ie, physician or nurse practitioner).Peer assessments can play an important role in characterizing the quality of care for complex patients with multiple interrelated chronic conditions, but reliability can be poor. Strategies to achieve adequate reliability for these assessments should be applied. These strategies include emphasizing outcomes measurement, providing more structured assessments to identify true differences in patient management, adjusting systematic bias resulting from the individual reviewer and their professional background, and averaging scores from multiple reviewers. Future research on the reliability of peer assessments should focus on improving the ability of process measures to differentiate among cases with respect to the quality of management and on identifying additional sources of systematic bias for both process and outcome measures. Explicit recognition of factors influencing reliability will strengthen efforts to develop sound measures for quality assurance.
Strategies for hepatocellular carcinoma therapy and diagnostics: Lessons learned from high throughput and profiling approaches
Authors: Kai Breuhahn, Gregory Gores, Peter Schirmacher
Journal: Hepatology (2011)

Over the last decade, numerous small and high-dimensional profiling analyses have been performed in human hepatocellular carcinoma (HCC), which address different levels of regulation and modulation. Because comprehensive analyses are lacking, the following review summarizes some of the general results and compares them with insights from other tumor entities. Particular attention is given to the impact of these results on future diagnostic and therapeutic approaches. (HEPATOLOGY 2011;)
Latent Metastasis From Carcinoma of the Thyroid
Authors: David L. Barrett
Journal: JAMA (1966)

<h3>To the Editor:—</h3> Drs. Richard Reed et al presented two interesting cases in "Latent Metastasis From Occult Sclerosing Carcinoma of the Thyroid" (<b>196</b>:233, 1966). The oncology of these small sclerosing carcinomas, as well as the rest of those of the papillary group, has been "confusing" as the authors commented. However, it is of considerable prognostic importance to classify these variously termed "non-encapsulated sclerosing tumors, sclerosing microcarcinomas, occult papillary carcinomas, and papillary microcarcinomas," under the papillary designation. The latter two terms are acceptable with that view in mind. Confusion arises in the fact that papillary carcinomas frequently show some follicle formation that mimics thyroid structure. The presence of an adenoid component of itself does not warrant classification of a neoplasm as follicular carcinoma, nor is the designation of "mixed papillary and follicular carcinoma" appropriate except in the extremely rare instance of collision tumors of those separate types. Because of the
Pseudopapilledema: Anomalous Elevation of Optic Disk
Authors: William F. Hoyt
Journal: JAMA (1962)

Anomalous optic disk elevation is not uncommon. Buried hyaline bodies in the tissue of the optic disk were considered the major cause of diagnostically troublesome pseudopapilledema in 28 patients originally thought to have brain tumors. Many of these patients had undergone numerous consultations and diagnostic procedures, including burr holes and ventriculography, before a mistaken diagnosis of papilledema was rectified. A noncongested, irregularly elevated optic disk which lacks a physiologic cup and which has no pathologic alteration in the retinal blood vessels should always suggest a diagnosis of pseudopapilledema. Management of a patient with such disk elevations should be conservative, provided that his other symptoms do not indicate neurosurgical investigation for brain tumor.
Left Ventricular Performance Following Digitalization in Patients with and without Heart Failure
Authors: GERALD W. MURPHY, BERNARD F. SCHREINER, PAUL L. BLEAKLEY, PAUL N. YU
Journal: Circulation (1964)

Nine patients, three with left ventricular failure and six with compensated heart disease, were studied by means of right and transseptal left heart catheterization during acute digitalization with acetyl strophanthidin. One of the patients with heart failure and a compensated subject with the Wolff-Parkinson-White syndrome were also studied during supine left leg exercise. In the decompensated group, digitalization produced a decrease in heart rate and increases in stroke index, stroke work, mean stroke power, mean systolic ejection rate, and the rate of pressure rise in the left ventricle. Left ventricular end-diastolic pressures were markedly lowered after digitalization. In the compensated group, no significant changes in cardiac index, stroke index, or mean systolic ejection rate were observed. Although there were small increases in stroke work and power and moderate decreases in left ventricular diastolic pressures, the most striking finding was an increase in the rate of rise of left ventricular systolic pressure. Digitalization produced considerable improvement in the circulatory response to light exercise in a patient with left ventricular failure. Less marked improvement in the exercise response was observed in a patient with normal hemodynamics. After digitalization, left ventricular function points plotted on the stroke work end-diastolic pressure diagram tended to shift upward and to the left in both decompensated and compensated patients. The shift of function points was most prominent in the decompensated group. This study demonstrates that, in the presence of myocardial failure, acetyl strophanthidin markedly augments left ventricular performance. Furthermore, the data suggest that digitalization also improves left ventricular performance in patients with left ventricular enlargement but no clinical manifestations of heart failure.
Rupture of an Infantile Umbilical Hernia
Authors: D. Harding-Jones, P. Robson
Journal: BMJ (1965)

The second potential collateral circulation lies between the inferior mesenteric and one or both iliac arteries.The ileo- lumbar and thoraco-epigastric arteries anastomose with the inferior mesenteric, circumflex iliac, and circumflex femoral arteries.This potential collateral circuit requires time to reach a useful degree of functional capacity and is not available when sudden obliteration of the superior mesenteric and internal iliac arteries occurs (Smith and Szilagyi, 1960).
Immune Deposits in Sural Nerve Biopsies from Patients with Paraneoplastic Polyneuropathy
Authors: T. M. Feltkamp-Vroom, B. W. Ongerboer de Visser, C. A. Feltkamp
Journal: Neuro-Oncology (1980)

Polyneuropathy, as a remote effect of malignant disease, is poorly understood. Metabolic factors, deficiency states and viral infection have been considered in the pathogenesis(1). Vasculitis (2), paraproteinaemia in myeloma (3) and immunopathologic factors are also reported as a cause for paraneoplastic neurological syndromes. The following data prompted us to study sural nerve biopsies with light, immunofluorescence and electron microscopy. Firstly, were proven circulating immune complexes found in patients with rheumatoid arthritis and Felty's syndrome with polyneuropathy in whom studies of sural nerve biopsies revealed immune deposits in the perineural membrane which consisted of immunoglobulin M (IgM) and thirdcomplement-component (C3) (own observation). Secondly, recently, circulating immune complexes have been demonstrated in carcinoma of uterine cervix (4), gastrointestinal tract (5), and the immune-complex induced glomerulopathies of neoplasia (6). From these data it seemed attractive to postulate that immune complexes might play a role in the induction of polyneuropathy in patients with malignant diseases.
M17 Survey assessing methods of vocal cord anaesthesia during bronchoscopy
Authors: DA Tarpey
Journal: Thorax (2013)

<h3>Introduction</h3> To anaesthetise the vocal cords during bronchoscopy there are 2 methods in general use, transcricoid lidocaine or lidocaine administered directly through the bronchoscope (direct vision). The choice between the two methods is down to individual operator choice and there has been little work comparing each method. We performed a survey assessing several aspects of bronchoscopy to see if there was a difference between the 2 approaches. <h3>Methods</h3> The bronchoscopist (one of three consultants and two registrars) and two nurses assessed patients degree of coughing, choking, sedation and overall tolerance of the procedure using a 10-point visual analogue scale. All patients were given 2–4 mg of midazolam as a sedative as is normal practice in our trust. Method of local anaesthesias and outcome of the bronchoscopy were noted. Results were analysed with a paired t test. <h3>Results</h3> 33 patients were assessed, 14 patients had direct vision lidocaine and 19 had transcricoid lidocaine. 2 of the procedures were abandoned due to patient’s intolerance (both in the direct vision group). There was a significant reduction in coughing (3.5 vs. 5.7 p value 0.009) choking (1.9 vs. 3.9 p 0.004) and overall tolerance was better in the transcricoid group (8.0 vs. 5.6 p 0.003). There was no difference in the degree of sedation ( 5.4 vs. 4.9 p 0.4). There was no significant difference in the amount of successful biopsies performed in each group. There was no difference in the amount of midazolam given to each group (2.65mg vs. 2.68mg) and the differences were preserved despite the individual bronchoscopist. <h3>Conclusions</h3> In this small pilot study The transcricoid group coughed and choked less and tolerated the procedure better in this survey. There was no difference between the groups in terms of sedation, total midazolam dosage or operator suggesting that this difference may due to the differing methods of local anaesthesia. A previous patient survey in our trust has shown patients themselves tolerated the transcricoid approach well. Further studies are needed to fully assess the differences between these two approaches and inform further practice.
Review: Adding dexamethasone to standard therapy reduces short-term relapse for acute migraine in the emergency department
Authors: Christopher R. Carpenter
Journal: Annals of Internal Medicine (2009)

Source Citation Singh A, Alter HJ, Zaia B. Does the addition of dexamethasone to standard therapy for acute migraine headache decrease the incidence of recurrent headache for patients treated in the emergency department? A meta-analysis and systematic review of the literature. Acad Emerg Med. 2008;15:1223-33. 18976336
Concurrent acute myeloid leukemia and systemic mastocytosis
Authors: K. F. Wong, J. K. C. Chan, T. C. Chow, J. C. W. Chan, S. K. Ma, Y. L. Kwong
Journal: American Journal of Hematology (1991)

A 51-year-old woman presented with concurrent systemic mastocytosis and acute myeloid leukemia associated with a clonal karyotypic anomaly of t(8;21). Cytochemical, histologic, and cytogenetic studies helped in the distinction from a recently described entity: acute myeloid leukemia with marrow basophilia. Although the leukemia responded well to aggressive chemotherapy, the mastocytosis component worsened, illustrating the inherent resistance of mastocytosis to chemotherapy.
Intercomparison of analytical methods for arsenic speciation in human urine.
Authors: E Crecelius, J Yager
Journal: Environmental Health Perspectives (1997)

An intercomparison exercise was conducted for the quantification of arsenic species in spiked human urine. The primary objective of the exercise was to determine the variance among laboratories in the analysis of arsenic species such as inorganic As (As+3 and As+5), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA). Laboratories that participated had previous experience with arsenic speciation analysis. The results of this interlaboratory comparison are encouraging. There is relatively good agreement on the concentrations of these arsenic species in urine at concentrations that are relevant to research on the metabolism of arsenic in humans and other mammals. Both the accuracy and precision are relatively poor for arsenic concentrations of less than about 5 micrograms/l.
THE EFFECT OF PAKTICLE SIZE AND VEHICLE ON THE PERCUTANEOUS ABSORPTION OF FLUOCINOLONE ACETONIDE.
Authors: C. W. BARRETT, J. W. HADGRAFT, G. A. CARON, I. SARKANY
Journal: British Journal of Dermatology (1965)

Journal Article THE EFFECT OF PAKTICLE SIZE AND VEHICLE ON THE PERCUTANEOUS ABSORPTION OF FLUOCINOLONE ACETONIDE. Get access C. W. BARRETT, C. W. BARRETT The Royal Free Hospital, London, W.C.I Search for other works by this author on: Oxford Academic Google Scholar J. W. HADGRAFT, J. W. HADGRAFT The Royal Free Hospital, London, W.C.I Search for other works by this author on: Oxford Academic Google Scholar G. A. CARON, G. A. CARON The Royal Free Hospital, London, W.C.I Search for other works by this author on: Oxford Academic Google Scholar I. SARKANY I. SARKANY The Royal Free Hospital, London, W.C.I Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 77, Issue 11, 1 November 1965, Pages 576–578, https://doi.org/10.1111/j.1365-2133.1965.tb14578.x Published: 01 November 1965
Shall The Journal be Removed to Washington?
Authors: Donald Maclean
Journal: JAMA (1891)

<h3>To the Editor:</h3> —To some men the arguments in favor of Chicago are too obvious and too numerous to require enunciation. Insane or insincere men I have neither time nor inclination to labor with. Yours for Chicago, ten thousand times Chicago! Detroit, Mich., Feb. 23, 1891.
General-practitioner obstetric beds in a consultant unit.
Authors: P. Rhodes
Journal: BMJ (1968)

Surgical Unit in Remote Area-Cumming MEDIBARLJOURNAL 509 greatly assists the integration of hospital and local authority medical services. ConclusionAt a time when the whole future of the small hospital is in the balance it is hoped that the foregoing survey helps to illustrate the extent to which local services can be developed, not with a view to achieving complete independence, but rather in closer integration with the larger hospitals and universities.Decisions on the degree of expansion which can be justified must be taken by careful appraisal of the interests of the patient on the one hand and the question of expense and efficiency on the other.Where a surgical unit of the type described is estab- lished in an area which is remote from the nearest large centre, and subject to irregular transport and communications, one must face the fact that the standards of staffing and equipment required may impose a level of expenditure which is out of pro- portion to the population served.The criteria employed in assessing such financial outlay are therefore entirely different from those which apply to the large hospital or to the small hospital which has easy access to the central complex.I wish to thank The Shetland Times, Ltd. for permission to reproduce Fig. 1, which is taken from The Islands of the North, by
Angiotensin II depolarizes podocytes in the intact glomerulus of the Rat.
Authors: J Gloy, A Henger, K G Fischer, R Nitschke, P Mundel, M Bleich, P Schollmeyer, R Greger, H Pavenstädt
Journal: Journal of Clinical Investigation (1997)

The aim of this study was to examine the effects of angiotensin II (Ang II) on cellular functions of rat podocytes (pod) in the intact freshly isolated glomerulus and in culture. Membrane voltage (Vm) and ion currents of pod were examined with the patch clamp technique in fast whole cell and whole cell nystatin configuration. Vm of pod was -38+/-1 mV (n = 86). Ang II led to a concentration-dependent depolarization of pod with an ED50 of 10(-8) mol/liter. In the presence of Ang II (10(-7) mol/liter, n = 20), pod depolarized by 7+/-1 mV. In an extracellular solution with a reduced Cl- concentration of 32 mmol/liter, the effect of Ang II on Vm was significantly increased to 14+/-4 mV (n = 8). The depolarization induced by Ang II was neither inhibited in an extracellular Na+-free solution nor in a solution with a reduced extracellular Ca2+ (down to 1 micromol/liter). Like Ang II, the calcium ionophore A23187 (10(-5) mol/liter, n = 9) depolarized pod by 10+/-2 mV, whereas forskolin (10(-5) mol/liter), 8-(4-chlorophenylthio)-cAMP and N2,2'-o-dibutyryl-cGMP (both 5 x 10(-4) mol/liter) did not alter Vm of pod. The angiotensin 1 receptor antagonist losartan (10(-7) mol/liter) completely inhibited the Ang II-induced (10(-7) mol/liter) depolarization (n = 5). Like pod in the glomerulus, pod in short term culture depolarized in response to Ang II (10(-8) mol/liter, n = 5). Our results suggest that Ang II depolarizes podocytes directly by opening a Cl- conductance. The activation of this ion conductance is mediated by an AT1 receptor and may be regulated by the intracellular Ca2+ activity.
Electron beam tomography permits to noninvasively rule out coronary artery stenoses in patients scheduled for noncoronary cardiac surgery
Authors: Stephan Achenbach, Dieter Ropers, Susanne Hauer, Theresa Menendez, Karsten Pohle, Ralph Maeffert, Magda Kusus, Matthias Regenfus, Werner Moshage, Werner G. Daniel
Journal: Journal of the American College of Cardiology (2002)
INSECTS AND WAR: XI.--THE MOSQUITO (Anopheles maculipennis)
Authors: A. E. Shipley
Journal: BMJ (1915)

_DlCALR'q-I 3 weak spot.G Great stupidity in attempts to conceal the crime, and absence of motive, are inmportant clues; the man who steals a loaf of bread to give to his starving famuily is probably normnal; tlle poor boy wlho robs bis ssister's money-box, and then scatters the coins among a crowd of children in the street, is probably defective.
Medical Students Trained Abroad and Medical Manpower
Authors: Barry Stimmel, John S. Graettinger
Journal: New England Journal of Medicine (1984)

Abstract Physicians trained in foreign medical schools, including U.S. citizens, are once again playing a larger part in the provision of medical care in this country. After a decrease in the numbers of such physicians from 1977 through 1980, the number of foreign nationals entering the National Resident Matching Program increased by 312 per cent, and the number of U.S. citizens from foreign schools increased by 273 per cent. U.S. graduates of foreign medical schools participating in Fifth Pathway programs appear to benefit from their extra year of clinical training by being more successful in the National Resident Matching Program and having a higher pass rate on state licensing examinations. These increases in physicians trained at foreign medical schools, together with an increasing number of students graduating from U.S. medical schools, have resulted in an insufficient total number of first-year postgraduate positions, regardless of the specialty, to accommodate all physicians seeking a first-year residency. Since the number of residency positions will probably not expand to meet applicant demand, an increase in the pool of physicians with neither residency training nor licenses to practice medicine is likely. Alien foreign medical-school graduates and U.S. students who go abroad to study medicine can no longer take for granted residency training and practice in the United States. (N Engl J Med 1984; 310:230–5.)
P69 * SCOTIN EXPRESSION AND SURVIVAL IN GBM
Authors: B. Qiao, K. Oneill, N. Syed
Journal: Neuro-Oncology (2014)

INTRODUCTION: Glioblastoma multiforme (GBM) is not only the most common primary brain tumour in adults but is also one of the most aggressive brain cancers. Currently there are no curative treatments available for patients with GBM. This is due to GBM having a highly disregulated genome leading to augmentation of survival pathways and defects in the apoptotic machinery. Targeting these defects may be of therapeutic value. Scotin, a pro-apoptotic mammalian gene induces apoptosis upon DNA damage or cellular stress. Its absence was reported in breast cancer and this correlated with earlier relapse and poor survival. In this study, the role of Scotin in inducing cell death/survival in GBM was investigated. METHOD: Scotin expression was examined in both primary and GBM cell lines using qPCR, western blotting and Methylation Specific PCR. The biological effects of scotin expression or downregulation (siRNA technology) was determined by proliferation assays, annexin V staining and autophagy assays in the presence of DNA damaging agents TMZ and Cisplatin. RESULTS: Scotin expression was absent in the majority of primary and GBM cell lines but expressed in normal astrocytes. No methylation was identified. Scotin modulated apoptosis and autophagy induced by the DNA damaging agents and this was independent of p53. CONCLUSION: Scotin may be used as a biomarker of chemoresistance/senstivity in GBM.