tbuckley/cabot-search huggingface dataset:
BMA calls for minimum 1% increase in doctors’ pay for 2013-14
Authors: Caroline White
Journal: BMJ (2012)

All doctors, including general practitioners, should be awarded at least a 1% pay rise next year to account for years of pay freezes and below inflation pay increases, the BMA has said.

The government has instructed the independent Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to consider awarding doctors a pay rise of 1% for 2013-14, but has suggested that the body does not need to make any recommendations on the gross contract uplift for general practitioners.

Earlier this week, NHS Employers called for the current public sector pay freeze to be extended for a further year for all NHS staff, arguing that the NHS could not afford any pay uplift without cutting jobs and …
Infectious Diseases and Medical Microbiology
Authors: Robert F. Betts
Journal: JAMA (1986)

It has been five years since the first edition of<i>Infectious Diseases and Medical Microbiology</i>appeared. Over 200 individuals from this country and around the world have contributed to this edition, most of whom also contributed to the previous edition. The book is divided into three sections. The first covers general principles of microbiology, bacteriology, virology, mycology, parasitology, and antimicrobial chemotherapy. The second section discusses specific microbial agents, with a brief review of general response to infection. The third section reviews the clinical infectious disease syndromes by organ system. A subsection on infections acquired from animals and factitious illness is provided. As with any textbook of this type, where the same subject matter is covered in two or possibly three sections, there is a tendency toward repetition. However, for the most part this has been avoided, since the initial section covers the characteristics of the organisms, eg, morphology, antigenic composition,
The Role of Computers in Medical Practice Management
Authors: Connie Henderson
Journal: JAMA (1982)

The author provides a good, understandable tool for those with limited computer experience who want to evaluate a computer system for a medical practice. The primary focus is on single-terminal, in-house computers costing under $20,000, and the limitations of such systems are pointed out. While the book concentrates on accounts receivable systems and insurance processing, there are brief sections on appointment scheduling and word processing as well. The author admits clinical and diagnostic applications are beyond the scope of this work. Ehrlich's practical approach is based on solid knowledge of practice management and hands-on computer experience. She avoids writing in "computerese," provides specific questions to ask when shopping for a computer system, and offers an excellent comparison of a manual accounting system and its computer counterpart, with illustrations. Good organization and charts make the book easy to read. Chapters address topics such as when do you need a computer, selecting
Lipolytic sensitivity and response to fasting in normotensive and hypertensive obese humans
Authors: Raymond R. Townsend, Samuel Klein
Journal: Metabolism (1997)

Obese persons with hypertension are at greater risk for diabetes and hyperlipidemia than normotensive obese persons. It has been postulated that increased lipolytic rates contribute to these metabolic diseases. Therefore, we evaluated the glycerol rate of appearance (Ra) in plasma, an index of whole-body lipolytic activity, during basal conditions and during 60 minutes of epinephrine infusion after 12 and 84 hours of fasting in six normotensive (body mass index [BMI], 39.9 ± 1.8 kg/m2) and six hypertensive (BMI, 38.7 ± 1.6 kg/m2) obese persons. Basal glycerol Ra was lower in hypertensive than in normotensive subjects at both 12 hours (1.58 ± 0.21 v 2.27 ± 0.26 μmol/kg/min, respectively; P < .01) and 84 hours (2.04 ± 0.06 v 2.50 ± 0.13 μmol/kg/min, respectively; P < .01) of fasting. Peak glycerol Ra during epinephrine infusion after 84 hours of fasting (5.69 ± 0.72 and 11.40 ± 0.78 μmol/kg/min for hypertensive and normotensive subjects, respectively) was significantly greater than at 12 hours (3.09 ± 0.29 and 5.06 ± 0.69 μmol/kg/min) in both hypertensive and normotensive subjects. However, peak glycerol Ra was lower in hypertensive than in normotensive subjects after 12 and 84 hours of fasting (P < .01 for 84 hours). We conclude that hypertension in obese persons is associated with a decrease in both basal lipolytic rates and lipolytic sensitivity to epinephrine infusion.
Double‐blind and placebo‐controlled study to assess efficacy and safety of a modified allergen extract of <i>Dermatophagoides pteronyssinus</i> in allergic asthma
Authors: A. Ameal, J. M. Vega‐Chicote, S. Fernández, A. Miranda, M. J. Carmona, M. C. Rondón, E. Reina, J. J. García‐González
Journal: Allergy (2005)

A randomized double-blind, placebo-controlled study was conducted in patients allergic asthma sensitized to Dermatophagoides pteronyssinus.To evaluate the efficacy and safety after 1-year of immunotherapy with a modified D. pteronyssinus extract compared with placebo.Fifty-five patients were randomly allocated to receive the active treatment (n = 29), or placebo (n = 26). The main outcome was the specific bronchial provocation test (BPT). Other parameters analysed were dose-response skin prick test (SPT), symptom and medication scores and asthma quality of life (AQLQ).At the end of the study, the active group showed a significant increase in the PD(20)FEV(1) compared with placebo (P = 0.0029). Nineteen patients of the active vs 10 of the placebo group needed more than twice the initial amount of allergen extract to have a positive BPT (P = 0.0293); seven patients in the placebo vs one in the active group needed less than half (P = 0.0137). In SPT, a significant improvement (P = 0.0049) was found in the active group. This group also had a median reduction of 91.5% in symptom scores, whereas the placebo group increased by 86%. Medication scores decreased in both groups (56% in the active and 11.4% in the placebo). In AQLQ, the differences between both groups were significant (P = 0.0234) at the end of the study.After 1 year of treatment, the modified extract of D. pteronyssinus demonstrated to be safe and efficacious to treat patients with asthma and allergic rhinoconjunctivitis sensitized to this mite.
The cost of cardiac surgery.
Authors: J L Monro, S Mollo, S Brookbanks, N Conway, J K Ross
Journal: BMJ (1978)

A study in Wessex has shown that at 1977 prices, and excluding the cost of equipment already installed in the unit, the cost of replacing a man's aortic valve in this unit is about 1800 pounds. Nevertheless, this seems a small price to pay for return to health and full working capacity, particularly since such patients no longer need to draw social security benefits and their tax contributions will return to normal, thus probably paying for the operation within two years.
When May a Couple Stop Using Condoms?
Authors: Robert S. Remis
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Sexual contact among both homosexual and heterosexual individuals represents an important mode of transmission of the human immunodeficiency virus (HIV), which is responsible for acquired immunodeficiency syndrome.<sup>1</sup>In Quebec, for example, sexual transmission accounts for over 95% of cases of acquired immunodeficiency syndrome.<sup>2</sup>Primary interruption of transmission of HIV is currently the only available means of preventing this type of transmission; in this regard, public health authorities have advised individuals at risk to modify their sexual behavior: specifically, such individuals should reduce the number of their sex partners, avoid high-risk sexual practices, and use condoms.<sup>1,3</sup>Though the effectiveness of condoms has not yet been conclusively proved, in vitro studies<sup>4</sup>and theoretical considerations suggest that their proper use provides a barrier to the sexual transmission of HIV. Nevertheless, the indications for condom use, especially among heterosexuals, have not yet been clearly defined. It is
Hydrogen ion concentration is not the sole determinant of muscle metaboreceptor responses in humans.
Authors: L I Sinoway, R F Rea, T J Mosher, M B Smith, A L Mark
Journal: Journal of Clinical Investigation (1992)

We examined the effects of exercise conditioning on muscle sympathetic nerve activity (MSNA) during handgrip and posthandgrip circulatory arrest (PHG-CA). Two conditioning stimuli were studied: forearm dominance and bodybuilding. Static handgrip at 30% maximal voluntary contraction followed by PHG-CA led to a rise in MSNA smaller in dominant than in nondominant forearms (99% vs. 222%; P less than 0.02) and in body builders than in normal volunteers (28% vs. 244%; P less than 0.01). Separate 31P NMR experiments showed no effect of dominance on forearm pH but a pH in bodybuilders higher (6.88) than in normal volunteers (6.79; P less than 0.02) during PHG-CA. Our second goal was to determine if factors besides attenuated [H+] contribute to this conditioning effect. If differences in MSNA during exercise were noted at the same pH, then other mechanisms must contribute to the training effect. We measured MSNA during ischemic fatiguing handgrip. No dominance or bodybuilding effect on pH was noted. However, we noted increases in MSNA smaller in dominant than nondominant forearms (212% vs. 322%; P less than 0.02) and in bodybuilders than in normal volunteers (161% vs. 334%; P less than 0.01). In summary, MSNA responses were less during exercise of conditioned limbs. Factors aside from a lessening of muscle acidosis contribute to this effect.
Chemotherapy-triggered cathepsin B release in myeloid-derived suppressor cells activates the Nlrp3 inflammasome and promotes tumor growth
Authors: Mélanie Bruchard, Grégoire Mignot, Valentin Derangère, Fanny Chalmin, Angélique Chevriaux, Frédérique Végran, Wilfrid Boireau, Benoit Simon, Bernhard Ryffel, Jean Louis Connat, Jean Kanellopoulos, François Martin, Cédric Rébé, Lionel Apetoh, François Ghiringhelli
Journal: Nature Medicine (2012)
Development of coronary artery disease in cardiac transplant patients receiving immunosuppressive therapy with cyclosporine and prednisone.
Authors: B F Uretsky, S Murali, P S Reddy, B Rabin, A Lee, B P Griffith, R L Hardesty, A Trento, H T Bahnson
Journal: Circulation (1987)

Coronary artery disease (CAD) has been shown in previous uncontrolled studies to be a limiting factor to long-term survival in patients undergoing cardiac transplantation and who were taking conventional immunosuppressive agents. To study the development of CAD after cardiac transplantation in patients taking the newer immunosuppressive agent cyclosporine, we prospectively performed yearly coronary arteriography on all eligible transplantation patients (first year, 57 patients; second year, 30 patients; third year, 14 patients). The prevalence of CAD by life table analysis was 18% at 1 year, 27% at 2 years, and 44% at 3 years. The occurrence of two or more major rejection episodes was associated (p less than .005) with the development of CAD. In two patients who died of CAD, coronary artery histology revealed subintimal inflammatory cellular infiltration in some lesions. These data demonstrate that the prevalence of CAD rises progressively over time and immunologic factors may be important in its development.
Is an information booklet for patients leaving hospital helpful and useful?
Authors: D. A. Sandler, J. R. Mitchell, A. Fellows, S. T. Garner
Journal: BMJ (1989)

OBJECTIVE--To determine whether a booklet given to patients being discharged from hospital giving details of their admission and treatment increased their knowledge and recall when reviewed in outpatient clinics. DESIGN--Patients alternately allocated to receive a booklet or to serve as controls. Assessment by a questionnaire at first attendance at outpatient clinic after discharge. Data were collected over nine months. SETTING--One general medical and cardiological ward in a large teaching hospital and associated outpatient clinics. PATIENTS--One hundred and thirty one patients discharged taking at least one drug and scheduled to return to clinic within 12 weeks. Patients stratified by age and by the number of weeks between discharge and outpatient appointment. INTERVENTION--A booklet was given to 65 patients at discharge from the ward; 66 patients served as controls. MAIN RESULTS--Of the patients who received the booklet, 56 (86%) knew the names of their drugs, 62 (95%) the frequency of the dose, and 55 (85%) the reasons for taking each drug. The numbers in the control group were 31 (47%), 38 (58%), and 28 (42%) respectively. These differences were highly significant (p less than 0.001). Twenty six (40%) who received the booklet brought all their drugs to clinic compared with 12 (18%) control patients. Appreciably more of the first group of patients than control patients knew the reason they had been in hospital, and more of the first group indicated that they would take the correct action when their prescribed drugs ran out. Most general practitioners thought that the booklet was a good idea, that it was helpful, and that it was better than the existing interim discharge letter. CONCLUSIONS--Giving patients an information booklet at discharge from hospital appreciably increased the accuracy and thoroughness of their recall of important medical details concerning their illness and its treatment. The booklet was shown to be feasible, helpful in the outpatient clinic, and preferred by most general practitioners.
Genomic and Molecular Characterization of Malignant Peripheral Nerve Sheath Tumor Identifies the IGF1R Pathway as a Primary Target for Treatment
Authors: Jilong Yang, Antti Ylipää, Yan Sun, Hong Zheng, Kexin Chen, Matti Nykter, Jonathan Trent, Nancy Ratner, Dina C. Lev, Wei Zhang
Journal: Clinical Cancer Research (2011)

Malignant peripheral nerve sheath tumor (MPNST) is a rare sarcoma that lacks effective therapeutic strategies. We gain insight into the most recurrent genetically altered pathways with the purpose of scanning possible therapeutic targets.We conducted a microarray-based comparative genomic hybridization profiling of two cohorts of primary MPNST tissue samples including 25 patients treated at The University of Texas MD Anderson Cancer Center and 26 patients from Tianjin Cancer Hospital. Immunohistochemistry (IHC) and cell biology detection and validation were carried out on human MPNST tissues and cell lines.Genomic characterization of 51 MPNST tissue samples identified several frequently amplified regions harboring 2,599 genes and regions of deletion including 4,901 genes. At the pathway level, we identified a significant enrichment of copy number-altering events in the insulin-like growth factor 1 receptor (IGF1R) pathway, including frequent amplifications of the IGF1R gene itself. To validate the IGF1R pathway as a potential target in MPNSTs, we first confirmed that high IGF1R protein correlated with worse tumor-free survival in an independent set of samples using IHC. Two MPNST cell lines (ST88-14 and STS26T) were used to determine the effect of attenuating IGF1R. Inhibition of IGF1R in ST88-14 cells using siRNAs or an IGF1R inhibitor, MK-0646, led to significant decreases in cell proliferation, invasion, and migration accompanied by attenuation of the PI3K/AKT and mitogen-activated protein kinase pathways.These integrated genomic and molecular studies provide evidence that the IGF1R pathway is a potential therapeutic target for patients with MPNST.
ABC of one to seven. Audit in primary care paediatrics.
Authors: L Peter
Journal: BMJ (1993)

Audit is the name given to the process of assuring the quality of the care that we deliver as health professionals.When we audit any aspect of our care we go through a series of steps, as follows: R-RAMS1 What are we doing?-Here we measure our actual performance.For example, what percentage of our asthmatic children have had a peak flow recordedn the past 6 months?2 What should we be doing?-Herewe decide what standard of care we should be aiming at.This step usually involves consensus among colleagues and reading recent publications.? 3 Comparing 1 and 2-Here we face up to how far short of our own standards we actually fall.Sometimes we are pleasantly surprised to find that we have reached them. 4 Negotiating change-At this stage we examine, with other relevant health professionals, the facets of our practice that need to be changed to ~allow us to get nearer to the standard that we have set.to see whether our changes have been instituted and whether they are working.This has to be done over again until the team is satisfied that 1 and 2 are as closed as possible.
Dangers of long waiting times for outpatient appointments at a urology clinic.
Authors: K German, F Nuwahid, P Matthews, T Stephenson
Journal: BMJ (1993)

Great pressure has recently been put on clinicians by hospital managers and politicians to reduce waiting times.Unfortunately, the emphasis of current initiatives on waiting lists tends to be on reducing the wait for surgery rather than the waiting time for an appointment at an outpatient clinic.We report the potential dangers of long waiting times
ROBISON NATIONAL CLEARING AND WORLD WIDE ADJUSTING COMPANIES
Authors: Frank J. Kendrick
Journal: JAMA (1931)

<h3>To the Editor:</h3> —I was interested in your article on the Robison National Clearing Company of Albany, N. Y. I have had a little experience with this company and believe that you should know about these things. In February, 1930, a representative of the World Wide Adjusting Company (a subsidiary of the Robison National Clearing Company) called at my office and asked that I give him some of my bad accounts, stating that his company was going to compile a book of Lagrange County, listing all "dead beats," whom they owed, etc. He stated that every one who turned over any accounts to him would secure one of these books. He canvassed business houses in town, telling the same story. He had a booklet, which he showed me, on another county, similar, he said, to the one to be prepared on Lagrange County. Being new and unacquainted in this community,
Glutathione<i>S-</i>Transferases M1 and P1 Prevent Aggravation of Allergic Responses by Secondhand Smoke
Authors: Frank D. Gilliland, Yu-Fen Li, Henry Gong, David Diaz-Sanchez
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Secondhand tobacco smoke (SHS) and traffic-related air pollutants are associated with asthma and allergy. Diesel exhaust particles (DEPs) and SHS can interact with allergens in exacerbating allergic airway diseases through generation of reactive oxygen species. Glutathione S-transferases (GSTs) metabolize reactive oxygen species and detoxify electrophilic xenobiotics present in SHS and DEPs.We tested the hypotheses that functional GSTM1-null genotype and GSTP1 codon 105 variants (Ile105 and Val105) are determinants of allergic responses to SHS, and that responses to SHS and DEPs are correlated.In a randomized, placebo-controlled crossover trial, 19 ragweed allergen-sensitive subjects who had previously participated in a DEP trial were challenged intranasally with allergen after having been exposed to either clean air or SHS at separate visits. Nasal allergen-specific IgE, histamine, IL-4, and IFN-gamma levels were measured before and after allergen challenge.Individuals with GSTM1-null or GSTP1 Ile105 genotypes showed larger nasal responses to allergens with SHS compared with clean air. GSTM1-null subjects had a larger increase in IgE than GSTM1-present subjects (median, 173.3 vs. 46.7 U/ml; p = 0.03), and the Ile105 GSTP1 genotype subjects had increased histamine (median, 10.2 vs. 4.6 nM; p = 0.01) after SHS plus allergen challenge. Responses to SHS and DEPs were correlated. Enhancement of IgE and histamine was greatest in the subjects with both the GSTM1-null and GSTP1 Ile/Ile genotypes.GSTM1 and GSTP1 are important cytoprotective factors that reduce SHS and DEP exacerbation of allergic responses.
PTH-198 Pooled Analysis of the most Frequent Adverse Events Associated with the use of Lubiprostone
Authors: T Joswick, G Dolecek, P Lichtlen, D Panigrahi, R Ueno
Journal: Gut (2013)

<h3>Introduction</h3> Lubiprostone, a novel ClC-2 activator, has been shown to be efficacious and well-tolerated by patients with chronic constipation in short- and long-term clinical trials. To better characterise the most frequent adverse events (AEs) associated with the use of lubiprostone 24 mcg BID, we examined pooled results of patients enrolled in Phase 2 and 3 trials of 3 to 48 weeks’ duration. <h3>Methods</h3> Data for all safety-evaluable patients were pooled and compared between treatment groups (placebo vs lubiprostone 24 mcg BID). Nausea, headache, and diarrhoea AEs were analysed in terms of severity, duration, frequency, action taken (eg, drug withdrawn, dose reduced), and outcome. In addition, nausea-related variables were explored in subpopulations of elderly (≥65 years of age) and male patients. <h3>Results</h3> The pooled population included 1113 lubiprostone and 316 placebo patients. Approximately 16% were elderly and 13% were male. At least 1 AE occurred in 79.1% of lubiprostone patients, which included 31.1% with nausea, 13.2% with headache, and 13.2% with diarrhoea. At least 1 AE occurred in 39.6% of placebo patients, which included 5.1% with nausea, 6.6% with headache, and 0.9% with diarrhoea. Of those lubiprostone patients who experienced nausea, 88.7% reported nausea to be mild or moderate in severity. Overall, 74.5% of nausea events reported by lubiprostone patients were intermittent, and the median durations of nausea events were 12 and 7.5 days for lubiprostone and placebo patients, respectively. Notably, mean incidences of nausea per patient were 1.3 and 1.0 for lubiprostone and placebo patients, respectively. With regard to action taken, 64.1% of nausea events required no change in treatment regimen, and 9.6% of events resulted in dose reduction. Nausea was less prevalent in subpopulations, occurring in only 18.8% and 8.2% of lubiprostone elderly and male patients, respectively, compared with 34.5% of female patients. Similarly, the majority of lubiprostone patients experiencing headache and diarrhoea had mild-to-moderate symptom severity (89.8% and 82.3%, respectively). Furthermore, headache and diarrhoea events in lubiprostone patients were mostly intermittent (64.2% and 74.0%, respectively), and the median duration of these events were 9 and 4 days, respectively. Discontinuation rates due to nausea, headache, and diarrhoea were 8.7%, 3.7%, and 2.2%, respectively. <h3>Conclusion</h3> Nausea, headache, and diarrhoea associated with lubiprostone use are generally mild to moderate in severity, intermittent, and limited in duration. <h3>Disclosure of Interest</h3> None Declared.
THE RELATION OF MOSQUITOES TO FILARIASIS IN THE REGION OF SAN FRANCISCO BAY
Authors: CREIGHTON WELLMAN
Journal: JAMA (1910)

The constant presence of filariasis in the cities border ing San Francisco Bay has long rendered it desirable to know if the indigenous mosquitoes of this region are afficient hosts for the parasite at the temperature normally found in this part of California. In other words it is a desideratum to learn if an Oriental infected with filariæ residing, for instance, in Oakland might be a menace to the community in which he lives. With this object in mind we have undertaken some experiments. <h3>REPORT OF EXPERIMENTS</h3><h3>The Source of the Filariæ.—</h3> A Japanese man, aged 29, was found on Dec. 10, 1909, to have sharp-tailed, sheathed filarial embryos in his night blood. This man came to San Francisco six years ago from Japan, stopping at Hawaii three months on the way. He went to Alaska four years ago and since his return to California ha residd or three yers