tbuckley/cabot-search huggingface dataset:
Mental Health Act: why not learn from devolution?
Authors: Richard Simpson
Journal: BMJ (2006)

How much will Herceptin really cost? Balancing local and national priorities is not newEditor-Herceptin for early stage breast cancer is a cost effective treatment, and it is right that the NHS should make it available.The challenge of funding new treatments and balancing local and national priorities is one the NHS has faced since its inception. 1 The process the National Institute for Health and Clinical Excellence (NICE) follows for evaluating new medicines is the most rigorous anywhere in the world, and local NHS organisations can have confidence that implementing our recommendations is an effective use of their resources.NICE's independent advisory committees do not rubber stamp decisions.They make them based on an objective and impartial interpretation of the evidence.Those who suggest otherwise should come forward with their evidence for doing so.It is wrong to suggest that a single recommendation from NICE will necessarily cause other services to be reduced and that these decisions are made by clinicians only.Many demands are made on available funds in any hospital at any one time and it is the responsibility of local NHS management, working with their clinical teams, to make the best use of these resources.This difficult job is made easier by NICE guidance and the support tools we offer, such as our commissioning guides and our forthcoming advice on shifting spending from less to more effective treatments.
Industrial Problems in the Middle East
Authors: A. M. Critchley, I. H. Flack
Journal: BMJ (1944)

NUTRITIONAL IRON DEFICIENCY ANAEMIA MEDICALJOURNAL between the levels of the two schools; but School III, which started lower, was on the final test significantly higher than School I.No explanation for this has been found.It would also appear from thie figures that the increases have tended to occur in the spring months (see Chart).90 1942 1943 t944 (64) (~~~O) (~~~~61) o CHOOLw 1
Increase in <i>de novo</i> HBV DNA integrations in response to oxidative DNA damage or inhibition of poly(ADP-ribosyl)ation
Authors: Maura Dandri, Martin R. Burda, Alexander Bürkle, David M. Zuckerman, Hans Will, Charles E. Rogler, Heimer Greten, Joerg Petersen
Journal: Hepatology (2002)

Chronic infection with hepatitis B virus (HBV) is associated with an increased risk for the development of cirrhosis and hepatocellular carcinoma (HCC). Although clonal HBV DNA integrations are detected in nearly all HCCs the role of these integrations in hepatocarcinogenesis is poorly understood. We have used a cloning protocol that allows studying the frequency and the natural history of HBV DNA integrations in cell culture. Southern blot analysis of the genomic DNA of HepG2 2.2.15 subclones, which replicate HBV, enabled us to detect new HBV DNA integrations in approximately 10% of the HepG 2.2.15 subclones over 4 rounds of sequential subcloning, whereas no loss of any preexisting HBV DNA integrations was observed. Treatments of HepG2 cells with H 2 O 2 , designed to increase DNA damage, increased the frequency of HBV integrations to approximately 50% of the subclones and treatments designed to inhibit DNA repair, by inhibiting Poly(ADP-ribosyl)ation, also increased the frequency of HBV integration to 50%. These findings suggest that DNA strand breaks induced by oxidative stress during persistent HBV infection in humans may increase HBV DNA integration events, whereas PARP-1 activity may function to limit the occurrence of de novo HBV DNA integrations.
Lung Growth and Airway Function after Lobectomy in Infancy for Congenital Lobar Emphysema
Authors: John T. McBride, Mary Ellen B. Wohl, Denise J. Strieder, Andrew C. Jackson, John R. Morton, Robert G. Zwerdling, N. Thorne Griscom, Salvador Treves, Adrian J. Williams, Samuel Schuster
Journal: Journal of Clinical Investigation (1980)

To characterize the outcome of lobectomy in infancy and the low expiratory flows which persist after lobectomy for congenital lobar emphysema, 15 subjects with this history were studied at age 8-30 yr. Total lung capacity was normal in all, but higher values (P < 0.05) were observed in nine subjects with upper lobectomy than in five subjects with right middle lobectomy. Ratio of residual volume to total lung capacity was correlated (P < 0.05) with the amount of lung missing as estimated from normal relative weights of the respective lobes. Xe133 radiospirometry in eight subjects showed that the operated and unoperated sides had nearly equal volumes at total lung capacity, but that the operated side was larger than the unoperated side at residual volume. Perfusion was equally distributed between the two sides. Similar findings were detected radiographically in four other subjects. Forced expiratory volume in 1 s and maximal midexpiratory flow rate averaged 72 and 45% of predicted, respectively. Low values of specific airway conductance and normal density dependence of maximal flows in 12 subjects suggested that obstruction was not limited to peripheral airways. Pathologic observations at the time of surgery and morphometry of the resected lobes were not correlated with any test of pulmonary function.
Leg Pain and Platelet Aggregates in Thrombocythemic Myeloproliferative Disease
Authors: Hatem H. Salem
Journal: JAMA (1980)

In three patients with thrombocytosis secondary to myeloproliferative disorders, disabling intermittent lower extremity pain occurred in the absence of peripheral vascular insufficiency. In all patients, circulating platelet aggregates were detected. Antiplatelet therapy resulted in prompt relief of pain and the disappearance of platelet aggregates. These findings suggest that abnormal platelet function with the formation of platelet plugs in the microcirculation could be responsible for the observed symptoms and response to treatment. The value of the determination of circulating platelet aggregates in the management of this syndrome is highlighted.
Increased Reactive Oxygen Species in Rostral Ventrolateral Medulla Contribute to Neural Mechanisms of Hypertension in Stroke-Prone Spontaneously Hypertensive Rats
Authors: Takuya Kishi, Yoshitaka Hirooka, Yoshikuni Kimura, Koji Ito, Hiroaki Shimokawa, Akira Takeshita
Journal: Circulation (2004)

Background— Oxidative stress increases in hypertension. The aim of this study was to determine whether reactive oxygen species (ROS) are increased in the rostral ventrolateral medulla (RVLM) in the brainstem, where the vasomotor center is located, in stroke-prone spontaneously hypertensive rats (SHRSP), and, if so, to determine whether the increased ROS contribute to neural mechanisms of hypertension in SHRSP. Methods and Results— We measured ROS levels in the RVLM of SHRSP and compared them with those in Wistar-Kyoto rats (WKY). Thiobarbituric acid–reactive substances were increased in SHRSP compared with WKY. ROS were measured by electron spin resonance (ESR) spectroscopy. The ESR signal decay rate in the RVLM of SHRSP was significantly increased compared with that in WKY, and this increase was abolished by dimethylthiourea (a hydroxyl radical scavenger). The increased ESR signal decay rate was reduced to the same extent in the presence of desferrioxamine, catalase, and Tiron, indicating that hydroxyl radicals are derived from superoxide anions and hydrogen peroxide. In addition, total superoxide dismutase (SOD) activity in the RVLM was decreased in SHRSP compared with WKY. Furthermore, bilateral microinjection of tempol into the RVLM decreased blood pressure in SHRSP but not in WKY, and MnSOD overexpression in the RVLM of SHRSP decreased blood pressure and inhibited sympathetic nerve activity. Conclusions— These results suggest that superoxide anions in the RVLM, which generate hydroxyl radicals, are increased in SHRSP and contribute to the neural mechanisms of hypertension in SHRSP.
Does One Person Provide It All? Primary Support and Advanced Care Planning for Women With Cancer
Authors: Don S. Dizon, Jennifer S. Gass, Christina Bandera, Sherry Weitzen, Melissa Clark
Journal: Journal of Clinical Oncology (2007)

We challenged a common clinical assumption that female cancer patients designate the same individual who provides them with primary support in advanced care planning roles.During 6 months, we conducted a survey of female cancer patients seen in a women's oncology program. Women were asked to name their health care proxy (HCP), emergency contact (EC), and primary support, and to define their own meaning of primary support. The person identified by chart review (C-ID) as that patient's primary contact was also abstracted. The frequency that the same person served all three roles was determined. Concordance between the C-ID and surveyed responses was calculated.Two hundred fifteen (98%) of 219 women agreed to participate. The median age was 58 years (range, 29 to 85 years). Women were surveyed a median of 14.3 months since diagnosis (range, 0.3 to 214 months). Although 80.4% of women surveyed named a first-degree relative to fill all three roles, only 56.7% of respondents identified the same individual for each of these roles. For those in relationships, 54% named their partner in all three roles. The majority of women characterized support as emotional (46.7%) or as emotional and structural (22.6%). Concordance was strongest between the C-ID and both EC and HCP.More than 40% of women with cancer in our sample did not name the same person for support and for advanced care planning roles. We also discovered a lack of uniformity in definitions of primary support. The implications of these findings on decision making and outcomes in women with cancer require additional study.
DOES THE AMOUNT OF RADIOFREQUENCY ENERGY DELIVERY OR ABLATION TECHNIQUE AFFECT POST-ABLATION 3RD MONTH HEART RATE VARIABILITY OR CLINICAL OUTCOME?
Authors: Jaemin Shim, Boyoung Joung, Hye Jin Hwang, Jong Sung Park, Jong Youn Kim, Moon-Hyoung Lee, Sung Soon Kim, Hui-Nam Pak
Journal: Journal of the American College of Cardiology (2011)
Enteroviruses Harness the Cellular Endocytic Machinery to Remodel the Host Cell Cholesterol Landscape for Effective Viral Replication
Authors: Olha Ilnytska, Marianita Santiana, Nai-Yun Hsu, Wen-Li Du, Ying-Han Chen, Ekaterina G. Viktorova, Georgy Belov, Anita Brinker, Judith Storch, Christopher Moore, Joseph L. Dixon, Nihal Altan-Bonnet
Journal: Cell Host & Microbe (2013)
Dietary "Fibre" and Pregnancy Toxaemia
Authors: E. H. Hipsley
Journal: BMJ (1953)

Six weeks later her weight was increasing and pulsation could be felt in the previously wccluded vessels. SummaryThe clinical course of nine patients suffering from temporal arteritis is described.The following points emerge: the patients are without exception elderly, often of arthritic disposition, and arteriosclerotic; the disease runs a protracted though benign course but may leave permanent damage to vision; temporal arteritis is a not uncommon cause of sudden visual failure in the elderly, and the underlying disease may be over- looked if the symptoms have not been severe or if they have occurred some weeks or months before ; salicylates are of value, at least in the relief of symptoms.The ischaemia of the scalp may be sufficient to result in necrosis.
Fundholding pilot allows inpatient purchases
Authors: A. Boulton
Journal: BMJ (1996)

A new pounds sterling100000 Department of Health initiative to allow fundholders to purchase mental health inpatient services for their patients is to be piloted by selected practices over the next two years. Mental health was a priority suggested by participating practices in the department's 1994 fundholding review.

Mental health is the second area of patient services to be piloted for total purchasing, following last April's maternity services initiative, which is due to run until …
CELL INTERACTIONS IN THE IMMUNE RESPONSE IN VITRO
Authors: Marc Feldmann
Journal: The Journal of Experimental Medicine (1972)

The requirement for macrophages in thymus-dependent antibody responses was studied in vitro. Three different macrophage-deficient cell populations were studied: spleen cells passed through a glass bead column at 37 degrees C, spleen cells cultured with specific antimacrophage serum, and thoracic duct lymphocytes. These cell populations from mice primed to dinitrophenylated (DNP) fowl gamma globulin were unable to respond to the homologous conjugate in vitro. DNP-reactive B cells were present in normal proportions, since all three macrophage-depleted populations responded normally to macrophage-independent and thymus-independent DNP flagella. Carrier-reactive T cells were present, as the helper capacity of carrier-primed spleen cells was the same as carrier-primed lymphocytes, and thoracic duct lymphocytes are a well-established source of helper cells. The inhibition of the cooperative response was thus due to removal of macrophages, and this was proven by restoration of thymus-dependent anti-DNP responses by small numbers of anti-theta-treated peritoneal exudate cells. These results suggest that macrophages are essential in cell collaboration, While their exact function in cell collaboration is not yet known, the above observation suggests that the mechanism of T-B collaboration involves the surface of macrophages.
Islet-reactive T cells are a marker of preclinical insulin-dependent diabetes.
Authors: L C Harrison, S X Chu, H J DeAizpurua, M Graham, M C Honeyman, P G Colman
Journal: Journal of Clinical Investigation (1992)

The destruction of pancreatic islet beta cells in insulin-dependent diabetes mellitus (IDDM) is thought to be T cell mediated. To directly identify islet-reactive T cells in asymptomatic, "preclinical" IDDM individuals with islet cell antibodies (ICA), proliferation of peripheral blood mononuclear cells (PBMC) was measured in the presence of sonicated fetal pig proislets. Stimulation indices (mean +/- SD) for [3H]thymidine uptake by PBMC cultured with sonicated proislets were: preclinical IDDM subjects (n = 22) 6.10 +/- 6.50, recent-onset IDDM subjects (n = 29) 3.66 +/- 3.35, Graves' disease subjects (n = 6) 2.17 +/- 0.93, scleroderma subjects (n = 4) 1.65 +/- 0.19 and normal control subjects (n = 14) 1.63 +/- 0.62. 68% (15/22) of preclinical IDDM, 41% (12/29) of recent-onset IDDM and 17% (1/6) of Graves' disease subjects had T cell reactivity greater than the mean + 2 SD of controls. T cell reactivity to proislets was tissue specific, and greater in magnitude and frequency than to human insulin. The majority of preclinical subjects with ICA greater than 20 Juvenile Diabetes Foundation (JDF) units (12/15, 80%) or antibodies to a 64-kD islet autoantigen (11/15, 73%) had significant T cell reactivity to proislets. ICA greater than 40 JDF units, a strong prognostic marker for progression to clinical IDDM, was an absolute index of T cell reactivity. Overall, the frequency of T cell reactivity in preclinical subjects, 68% (15/22), was comparable to that of ICA greater than 20 JDF units or 64-kD antibodies. Greater T cell reactivity to proislets in preclinical subjects accords with the natural history of autoimmune beta cell destruction. The direct assay of islet-reactive T cells in peripheral blood may have prognostic significance for the development of clinical IDDM and should facilitate identification of the primary target autoantigen(s).
A Comparison of the Quality of Maternity Care between a Health-Maintenance Organization and Fee-for-Service Practices
Authors: Susan Wilner, Stephen C. Schoenbaum, Richard R. Monson, Richard N. Winickoff
Journal: New England Journal of Medicine (1981)

An intense controversy surrounds the promotion of the health-maintenance organization (HMO) as an alternative to the traditional fee-for-service (FFS) system of medical care. Advocates of HMOs believe that this system can produce considerable savings without sacrificing the quality of care.1 , 2 Opponents have charged that HMOs keep costs down by "skimming" their enrollment from the younger and healthier segments of the population and by "skimping" on the provision of services even when they are medically indicated.3 An issue still under discussion is whether HMOs deliver health care of a quality comparable to that of the FFS sector.4 Using multiple indicators of . . .
Structural abnormalities in deficit and nondeficit schizophrenia
Authors: Robert W. Buchanan, Alan Breier, Brian Kirkpatrick, Ahmed Elkashef, Robert C. Munson, Fouad Gellad, William T. Carpenter
Journal: American Journal of Psychiatry (1993)

Previous studies have suggested the involvement of the frontal and parietal cortices and thalamus in a neural circuit underlying the production of primary enduring negative or deficit symptoms of schizophrenia. The purpose of this study was to examine whether structural changes in the proposed circuit are associated with the production of deficit symptoms.Magnetic resonance imaging was used to measure the volume of selected circuit brain regions (i.e., the prefrontal region and caudate) and noncircuit brain regions (i.e., the amygdala/hippocampus complex) in 17 deficit and 24 nondeficit schizophrenic outpatients and 30 normal comparison subjects.Right and left total prefrontal volumes discriminated deficit from nondeficit patients, with prefrontal volumes being smaller in nondeficit patients. There were no differences between the two schizophrenic subgroups in left caudate or right and left amygdala/hippocampus complex volumes. The right caudate was larger in deficit patients, but the difference between the two schizophrenic subgroups was not significant. There were no differences between deficit and normal subjects on any prefrontal region measure. Nondeficit patients had smaller total right and left prefrontal volumes than normal subjects. Both schizophrenic subgroups had larger left caudate volumes and smaller right and left amygdala/hippocampus complex volumes than the normal subjects. There was a trend for deficit patients to have larger right caudate volumes.These results suggest that structural changes in the prefrontal region are not responsible for deficit symptoms. The caudate, particularly the right caudate, may be associated with the production of these symptoms.
INSOLUBLE PRECIPITATES IN DIPHTHERIA AND TETANUS IMMUNIZATION
Authors: A. T. Glenny
Journal: BMJ (1930)

T19Hoccur nior does conitraction commiilonly set in as a later event.In the usual form of glomerulo-nephritis, on the otlher lhanid, the degree of capi'lialay bb)ckage is muJh g-ieater, leadinig to functionless lhyaline gloinieruli, atroplhied tulbules, contraction of the kidneys, and to uraemia.
Reply to A. Levy et al
Authors: Rajul K. Jain, J. Jack Lee, David Hong, Razelle Kurzrock
Journal: Journal of Clinical Oncology (2012)

I felt it was imperative that I object to the conclusions offered by Nakakura 1 as he commented about the research article by Chua et al. 2 In my opinion, Nakakura is suggesting that the serious mistakes in the history of management of mucinous appendiceal neoplasms should again be considered as treatment options.Nakakura sums up his editorial by asking the question "Can a better balance of good outcome with minimal morbidity be attained with function-preserving, debulking surgery versus aggressive cytoreductive surgery?" 1(p2430) The research article by Chua et al 2 and 10 of the 11 references listed by Nakakura should tell him that the answer to this question is an emphatic no.To support the function-preserving, debulking surgery, Nakakura 1 selects a single manuscript from Memorial Sloan-Kettering (MSK) that was published in 2005. 3The article suggested that it was the biology of the disease that determined outcome and that absolute cure as defined by a prolonged disease-free state was uncommon.When this article came out, I compared the
Darzi review: Government publishes a constitution for the NHS
Authors: A. Cole
Journal: BMJ (2008)

The first ever NHS constitution, enshrining the principles and values of the 60 year old service, will take effect from later this year.

The constitution, thought to be the first of its kind in the world, pulls together existing rights, responsibilities, and pledges in one document. It includes what the government says is a new right—the right for patients to make choices about their NHS care, including choosing their general practice and expressing a preference for using a particular doctor.

The constitution will be reviewed every 10 years and will be accompanied by a handbook that sets out current guidance. This will be revised every three years.

The draft constitution follows year long discussions with staff, patients, and the public. It reaffirms that the NHS is a comprehensive service; that access should be based on clinical need, not an individual’s ability to …
The recurrent attender with a difference
Authors: Richard Body
Journal: BMJ (2004)

ConclusionAs well as being common in partially sighted people, Charles Bonnet syndrome occurs in 1.85-3.5% of psychogeriatric patients who have been referred to psychiatrists by adult physicians, general practitioners, and ophthalmologists for visual hallucinations. 1 10 11 Doctors are unfamiliar with the syndrome as a possible diagnosis. 1 12"Near misses" have been reported, in which patients were almost confined to mental health institutions. 13Given the prevalence of partial visual impairment, the number of people in the community, especially elderly people, who do not report the symptoms for fear of being labelled as mentally unwell or demented must be substantial.Clinicians must therefore be aware and ask elderly people with visual impairment whether they have hallucinations.Firm reassurance that the syndrome is not related to mental illness is in itself a major relief to an elderly person burdened already with failing vision, social isolation, and other medical problems.
Expression of int-2 oncogene in Kaposi's sarcoma lesions.
Authors: Y Q Huang, J J Li, D Moscatelli, C Basilico, A Nicolaides, W G Zhang, B J Poiesz, A E Friedman-Kien
Journal: Journal of Clinical Investigation (1993)

Fibroblast growth factors (FGFs), such as basic FGF, have been implicated in the growth of Kaposi's sarcoma (KS) cells in vitro. In the evaluation of the expression of the various genes of the different members of the FGF family and their receptors in fresh KS tissue specimens, int-2 was found to be expressed in more than half of the KS tumors examined. Using reverse transcription PCR, the expression of int-2 was detected in 21 of 38 (55.2%) fresh KS biopsy specimens. In contrast, int-2 mRNA transcripts were not found in normal appearing skin from the same patients except in one sample which was obtained from an AIDS patient with disseminated KS lesions. Sequence data confirmed that the amplified sequences were derived from int-2 mRNA with proper splicing. In addition, 12 nucleic acid alterations were identified in eight out of nine KS tumor samples sequenced. Using immunohistochemical methods, int-2 protein was detected in some of the spindle-shaped tumor cells surrounding the abnormal endothelial-lined vascular slits histologically characteristic of KS. Int-2 specific immunostaining was shown to be present in both the nuclei and cytoplasm of these spindle cells but was more pronounced in the nuclei. Neither amplification nor gross rearrangement of the int-2 gene was detected in KS lesions by Southern blot analysis. These results suggest that the expression of int-2 may play a role in the pathogenesis KS by stimulating local angiogenesis and cell proliferation.