tbuckley/cabot-search huggingface dataset:
Spacer device with face mask attachment for giving bronchodilators to infants with asthma.
Authors: C. O'Callaghan, A. D. Milner, A. Swarbrick
Journal: BMJ (1989)

the ratings of different diagnostic groups yielded no significant differences except that "being in hospital" was more highly regarded by those with alcohol or drug dependence, manic patients rating this as the least helpful (one way analysis of variance; df= 6; F = 2 224; p<O005). CommentIronically this study shows that the thing psychiatric inpatients value most about being in hospital is their ability to leave.Of the therapeutic items, simply talking to a care giver, be they doctor or nurse, was widely regarded as the most helpful aspect of care.We emphasise that, unlike some American studies,' the sample contained many highly disturbed psychotic patients.Nevertheless, being able to confide in a member of staff was still regarded as rewarding.Contact with other patients, both informally and in ward groups, was not judged favourably.This may be unduly confrontational for some, yet for others may provide a degree of support and exchange of information unavailable elsewhere.Drug treatment was judged on average to be only "quite helpful."The professionals' opinions were not surveyed, but from the consumer's point of view psychiatric training would be well advised to pay as much attention to "talking therapy" as it does to hospitalisation, treatment with drugs, occupational therapy, and ward rounds.We conclude that just as patients need help to understand the benefits of their drug treatment, so doctors need to be reminded that the time given to talking to the mentally ill in hospital, albeit less than one hour a week according to three quarters of our sample, is time well spent.KM's participation was made possible by an Astor Sclare scholarship.ASD is supported by the Medical Research Council.We thank the patients and staff of the Bethlem Royal and Maudsley Hospitals for their cooperation.
89 A TRANSPOSON-BASED PRIMARY TUMOR RESECTION MODEL OF INTRAHEPATIC CHOLANGIOCARCINOMA (ICC) WITH EXTRAHEPATIC DISTANT METASTASES
Authors: E. Gürlevik, B. Fleischmann-Mundt, N. Armbrecht, T. Longerich, N. Woller, A. Kloos, L. Zender, M. Manns, F. Kühnel, S. Kubicka
Journal: Journal of Hepatology (2013)
Insulin binding sites in various segments of the rabbit nephron.
Authors: R Nakamura, D S Emmanouel, A I Katz
Journal: Journal of Clinical Investigation (1983)

Insulin binds specifically to basolateral renal cortical membranes and modifies tubular electrolyte transport, but the target sites of this hormone in the nephron have not been identified. Using a microassay that permits measurement of hormone binding in discrete tubule segments we have determined the binding sites of 125I-insulin along the rabbit nephron. Assays were performed under conditions that minimize insulin degradation, and specific binding was measured as the difference between 125I-insulin bound in the presence or absence of excess (10(-5) M) unlabeled hormone. Insulin monoiodinated in position A14 was used in all assays. Specific insulin binding (attomol . cm-1 +/- SE) was highest in the distal convoluted tubule (180.5 +/- 15.0) and medullary thick ascending limb of Henle's loop (132.9 +/- 14.6), followed by the proximal convoluted and straight tubule. When expressed per milligram protein, insulin binding capacity was highest along the entire thick ascending limb (medullary and cortical portions) and the distal convoluted tubule, i.e., the "diluting segment" (congruent to 10(-13) mol . mg protein-1), and was lower (congruent to 4 X 10(-14) mol . mg protein-1), and remarkably similar, in all other nephron segments. Binding specificity was verified in competition studies with unlabeled insulin, insulin analogues (proinsulin and desoctapeptide insulin), and unrelated hormones (glucagon, 1-34 parathyroid hormone, prolactin, follicle-stimulating hormone). In addition, serum containing antiinsulin receptor antibody from two patients with type B insulin resistance syndrome markedly inhibited insulin binding to isolated tubules. Whether calculated per unit tubule length or protein content, insulin binding is highest in the thick ascending limb and the distal convoluted tubule, the same nephron sites where a regulatory role in sodium transport has been postulated for this hormone.
Military Retirement: The Retirement Syndrome
Authors: JOHN S. MCNEIL, MARTIN B. GIFFEN
Journal: American Journal of Psychiatry (1967)

The stresses unique to military retirement are described as a growing medical and social problem. in anticipation of or following retirement from the service, the retiree may develop psychiatric symptoms or experience an exacerbation of previously resolved medical problems. The authors stress the importance of early detection and treatment of retirement maladjustment.
Class III antiarrhythmic action by potassium channel blockade: dofetilide attenuates hypoxia induced electromechanical changes
Authors: T. Yang, P. M Tande, D. A Lathrop, H. Refsum
Journal: Cardiovascular Research (1992)

The aim was to examine the electromechanical effects of dofetilide, a new class III antiarrhythmic agent, in isolated guinea pig ventricular muscle during hypoxia.Hypoxia was induced by superfusing guinea pig right ventricular papillary, muscles with Tyrode's solution gassed with 95% N2 + 5% CO2 [PO2 = 5.3(SEM 1.3) kPa]. Prior to hypoxia, the preparations were either pretreated for 30 min with 0.1 microM dofetilide (n = 6) or with 100 microM glibenclamide (a blocker of ATP sensitive K+ channels, n = 6), or not pretreated (n = 6). Sixteen additional preparations were exposed to 1 mM nicorandil (an activator of ATP sensitive K+ channels) in the absence (n = 6) and presence of dofetilide (n = 6) or glibenclamide (n = 4). Transmembrane action potentials and developed force were recorded using conventional microelectrode techniques and a force transducer.During normoxia, dofetilide markedly increased APD90 from 236(SEM 6) ms to 298(7) ms (p < 0.05) and the effective refractory period (ERP) from 248(5) ms to 315(6) ms (p < 0.05). In the drug free group, 60 min hypoxia decreased APD90 by 47(5)% (p < 0.05), ERP by 48(4)% (p < 0.05) and developed force by 71(6)% (p < 0.05) of baseline, respectively. These hypoxia induced effects were significantly attenuated after pretreatment with dofetilide or glibenclamide. Nicorandil decreased APD90 by 45(5)% (p < 0.05), ERP by 44(6)% (p < 0.05), and developed force by 69(10)% (p < 0.05) of baseline, respectively. Pretreatment with dofetilide or glibenclamide also significantly attenuated the nicorandil induced decreases in APD90, ERP, and developed force.Dofetilide, like glibenclamide, effectively attenuates hypoxia and nicorandil induced action potential shortening and the associated reduction in contractile force. Thus dofetidile would be expected to retain its antiarrhythmic efficacy during myocardial hypoxia or ischaemia.
Reduction of Mortality in Rural Haiti through a Primary-Health-Care Program
Authors: Warren L. Berggren, Douglas C. Ewbank, Gretchen G. Berggren
Journal: New England Journal of Medicine (1981)

Abstract Deaths and their causes in a rural Haitian population of 8820 were studied through hospital records, death registration, a disease survey, and health surveillance. The results were used in selecting eight diseases for the delivery of health services by village-level health workers. The impact of the services was measured by monitoring annual age-specific and disease-specific mortality rates and by comparing them with officially estimated national mortality rates. Mortality rates fell progressively during five years, to levels only one fourth as high as the national estimates. The fall in mortality was associated principally with services that prevented deaths due to tetanus, malnutrition, diarrhea, and tuberculosis. The total program of hospital and village health services saved 495 years of potential life per thousand population per year. Most of the saving was attributable to preventive services. The program eventually served more than 115,000 persons, and it has been replicated by other agencies for an additional 135,000 Haitians. (N Engl J Med. 1981; 304:1324–30.)
Malaria in Somalia: Lessons in Prevention-Reply
Authors: Mark R. Wallace
Journal: JAMA (1995)

In Reply.  —We wish to applaud the efforts of the navy preventive medicine community for their efforts in Operation Restore Hope. As noted by Dr Ledbetter and colleagues, aggressive prophylactic measures were taken to reduce the incidence of malaria in our troops. The success of this extraordinary effort is reflected in a malaria acquisition rate of only 1% in the 13 500 Marines initially deployed.  Despite this success, there were some problems with prophylactic measures taken in the subset of patients who acquired malaria. Because our series included only those patients who were diagnosed with malaria, we acknowledge that our sample cannot be extrapolated to those marines who did not develop malaria. Our cohort of malaria patients is obviously more likely either to have been noncompliant with prophylaxis or to have been offered a suboptimal prophylactic regimen. As we noted, one half of all patients with imported malaria reported receiving
Quality of care through the patient's eyes
Authors: T. L Delbanco
Journal: BMJ (1996)

As techniques to measure the quality of health care proliferate and improve, health professionals are beginning to understand that patients and their families hold unique vantage points as expert witnesses to care. For some time, hoteliers, bankers, car manufacturers, and politicians have been enthralled by information about the public's view of their services, including anecdotes, insights offered by focus groups, and data gathered from large scale surveys. Slow to turn to new fashions, health professionals are now learning that those they serve can make important suggestions as individuals, generate worthy hypotheses in small groups, and provide aggregate data through surveys that describe what is and is not going well and that can document the impact of efforts to improve.

Unfortunately, “satisfaction surveys” are fraught with hazards. As Cohen and colleagues show (p 841), surveys may produce widely varying data depending on how questions are framed and when and how they are asked.1 Moreover, uncertainty is compounded when one problematic set of data is compared to another obtained with even slightly differing …
Diameters of subendocardial arterioles and venules during prolonged diastole in canine left ventricles.
Authors: O Hiramatsu, M Goto, T Yada, A Kimura, H Tachibana, Y Ogasawara, K Tsujioka, F Kajiya
Journal: Circulation Research (1994)

Using a needle-probe videomicroscope with a charge-coupled device (CCD) camera, we measured the diameter of subendocardial arterioles and venules during prolonged diastole beyond the time point at which coronary blood flow reached zero. In seven open-chest heart-blocked dogs, a sheathed needle probe with a doughnut-shaped balloon was introduced from the left atrial appendage and advanced into the left ventricle through the mitral valve. The tip of the probe was placed gently on the endocardial surface. Diameters of arterioles (n = 16) and venules (n = 16) at the beginning of long diastole ranged from 40 to 126 microns and from 32 to 192 microns, respectively. After cardiac arrest, the arteriolar diameter gradually declined with aortic pressure. Arteriolar diameters at zero flow decreased by 28 +/- 9% (mean +/- SD) compared with the initial diameter (P &lt; .01). However, none of the subendocardial arterioles collapsed at zero flow or at 12 seconds after the beginning of prolonged diastole (8 to 9 seconds after zero flow) in an additional experiment (n = 5). In contrast to arteriolar diameter, venular diameter increased during prolonged diastole. Venular diameter at zero flow increased by 14 +/- 12% compared with the initial diameter (P &lt; .01). We conclude that during prolonged diastole, when coronary arterial inflow ceases, subendocardial arteriolar diameter decreases without any visible collapse, whereas venular diameter increases.
High Gene Expression of <i>TS1</i>, <i>GSTP1</i>, and <i>ERCC1</i> Are Risk Factors for Survival in Patients Treated with Trimodality Therapy for Esophageal Cancer
Authors: Mary-Beth Moore Joshi, Yoshinori Shirota, Kathleen D. Danenberg, Debbi H. Conlon, Dennis S. Salonga, James E. Herndon, Peter V. Danenberg, David H. Harpole
Journal: Clinical Cancer Research (2005)

To assess the relationship between molecular markers associated with chemotherapy resistance and survival in esophageal cancer patients treated with trimodality therapy.The original pretreatment formalin-fixed, paraffin-embedded endoscopic esophageal tumor biopsy material was obtained from 99 patients treated with concurrent cisplatin plus 5-fluorouracil plus 45 Gy radiation followed by resection at Duke University Medical Center (Durham, NC) from 1986 to 1997. cDNA was derived from the biopsy and analyzed to determine mRNA expression relative to an internal reference gene (beta-actin) using fluorescence-based, real-time reverse transcription-PCR. Possible markers of platinum chemotherapy association [glutathione S-transferase pi (GSTP1) and excision cross-complementing gene 1 (ERCC1)] and 5-fluorouracil association [thymidylate synthase 1 (TS1)] were measured.Cox proportional hazards model revealed a significant inverse, linear effect for TS1 with respect to survival (P = 0.007). An inverse relationship between TS1 expression and treatment response was also detected (P < or = 0.001). Univariate analysis identified an association with decreased survival for GSTP1 > or = 3.0 (P = 0.05). In multivariate analyses, TS1 >6.0, ERCC1 >3, and GSTP1 >3 were statistically significant predictors of decreased survival (P = 0.007). Additionally, the presence of ERCC1 >3.0 or TS1 >6.0 was associated with an approximately 2-fold increase in the risk of cancer recurrence (P = 0.086 and 0.003, respectively).The measurement of relative gene expression of molecular markers associated with chemoresistance in endoscopic esophageal tumor biopsies may be a useful tool in assessing outcome in patients with trimodality-treated esophageal cancer. These data should be validated further in larger prospective studies.
Auditors find NHS financial performance good overall
Authors: J. Wise
Journal: BMJ (2009)

The overall financial performance of NHS trusts and primary care trusts (PCTs) in England is good and improving, the Audit Commission has concluded.

But the independent watchdog says that there is still room for improvement, with nine NHS trusts failing to meet minimum standards this year and with relatively few assessed as performing strongly. The overall financial performance of PCTs was good, but no PCT received an excellent rating this year.

The commission has published its annual financial performance tables that assess how NHS trusts and PCTs manage their resources and whether they deliver value for money. It found that 93% of NHS trusts (116 trusts) met or exceeded minimum standards, compared with 91% in 2007-8. Nine per cent of NHS trusts (11 trusts) were assessed …
Hazards of pharmacological tests of growth hormone secretion.
Authors: T. C. Boto, G. Thomas, R. M. Eltreki
Journal: BMJ (1992)

reports (b) "medical records" and "patient education"; (c) administration of drugs, there is no equivalent for "medical records" and "attitude to health"; (d) documenting problems after investigations and SIR,-All learned journals require that their "4medical records" and "patient participation"; alerting the medical community of associated authors have satisfactorily reviewed published or (e) "medical records" and "health education."risks, and thus their report is valuable.It is well work.Over the past decade there have been several(A list of 101 references on the subject of patients' known among growth specialists, however, that critcal evies o autors'use f satisics'and access to records, of which 53 are to original insulin induced hypoglycaemia is potentially recommendations to try to tighten up the use and research, is available.)dangerous, and at least one child was previously presntaion f satisics2 Isi o iet oteIf scientific knowledge of medicine and health known to have died after an insulin tolerance test.same for the review of published reports?It services is to progress we need to make full use Shah and colleagues highlight the danger of sometimes seems as if authors have Hiot read, or of the work of others.In the United States reversing the hypoglycaemia with excessive choose to ignore, previous reports.MEDLINE is now being used effectively in quantities of hyperosmolar glucose solutions, Short reports in the BMJ7, by the rules of sub-routine clinical practice."jennett et al argue that which probably caused or exacerbated cerebral mission, must have no more than five references.' the use of a bibliographic searching tool such as oedema.But I challenge the necessity of usingIn their short report on patients' access to their MEDLINE should be an element in the medical a test th'at carries such a risk, whatever the own psychiatric records Morris Bernadt and col-undergraduate curriculum.'"Perhaps also research mechanism of cerebral oedema and death, to leagues make use of only three,' one of which is to journals should require their authors to include investigate short stature when other, safer tests are the Access to Health Records Act.They begin details of their method of searching published available.theirdiscusionwith he wrds, The ew reorts work.The insulin tolerance test is still probably the thatteireareusioaboth the condsequTene o f e rpatiets RAY JONES most commonly used provocation test for growth thavingeracces aoto thei mdcalserencesords.thiensDepartment of Public Health, hormone secretion and is regarded as the gold assertion is not supported by examination of UieitofGlasgow.
Adoption of Multi-Gene Assays in HR +, HER2– Breast Cancer (BC) Patients in Europe: Results of the Multidisciplinary Application of Genomics in Clinical Practice (MAGIC) Survey
Authors: M.S. Aapro, M. De Laurentiis, E. Mamounas, M. Martin, D. Rea, R. Rouzier, V. Smit, C. Thomssen
Journal: Annals of Oncology (2014)
Case 46-1963
Authors: John D. Stoeckle, Robert E. Scully
Journal: New England Journal of Medicine (1963)

Presentation of CaseA seventy-two-year-old man was referred to the hospital because of jaundice.Two months previously the patient experienced the onset of swelling of the abdomen, associated with anorexia, loss of weight and weakness. Three weeks before admission he became jaundiced and on several occasions passed clay-colored stools and dark urine; there was no abdominal pain, melena, hematemesis, chill, fever, fatty-food intolerance or dysuria. He had had no recent injections, exposure to toxins or contact with anyone with jaundice. He had ingested small amounts of alcohol for many years, but allegedly never drank excessively. Moderate constipation had occurred for . . .
Celebrating Minimalism in Residency Training
Authors: Deborah Korenstein, Cynthia D. Smith
Journal: JAMA Internal Medicine (2014)

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An essential role for monocyte chemoattractant protein-1 in alcoholic liver injury: Regulation of proinflammatory cytokines and hepatic steatosis in mice
Authors: Pranoti Mandrekar, Aditya Ambade, Arlene Lim, Gyongyi Szabo, Donna Catalano
Journal: Hepatology (2010)

Abstract The importance of chemokines in alcoholic liver injury has been implicated. The role of the chemokine, monocyte chemoattractant protein-1 (MCP-1), elevated in patients with alcoholic liver disease is not yet understood. Here, we evaluated the pathophysiological significance of MCP-1 and its receptor, chemokine (C-C motif) receptor 2 (CCR2), in alcoholic liver injury. The Leiber-DeCarli diet containing alcohol or isocaloric control diets were fed to wild-type (WT) and MCP-1-deficient knockout (KO) mice for 6 weeks. In vivo and in vitro assays were performed to study the role of MCP-1 in alcoholic liver injury. MCP-1 was increased in Kupffer cells (KCs) as well as hepatocytes of alcohol-fed mice. Alcohol feeding increased serum alanine aminotransferase in WT and CCR2KO, but not MCP-1KO, mice. Alcohol-induced liver steatosis and triglyceride were attenuated in alcohol-fed MCP-1KO, but high in CCR2KO mice, compared to WT, whereas serum endotoxin was high in alcohol-fed WT and MCP-1KO mice. Expression of liver proinflammatory cytokines tumor necrosis factor alpha, interleukin (IL)-1β, IL-6, KC/IL-8, intercellular adhesion molecule 1, and cluster of differentiation 68 was induced in alcohol-fed WT, but inhibited in MCP-1KO, mice independent of nuclear factor kappa light-chain enhancer of activated B cell activation in KCs. Oxidative stress, but not cytochrome P450 2E1, was prevented in chronic alcohol-fed MCP-1KO mice, compared to WT. Increased expression of peroxisome proliferator-activated receptor (PPAR)α and PPARγ was accompanied by nuclear translocation, DNA binding, and induction of fatty acid metabolism genes acyl coenzyme A oxidase and carnitine palmitoyltransferase 1A in livers of alcohol-fed MCP-1KO mice, compared to WT controls. In vitro assays uncovered an inhibitory effect of recombinant MCP-1 on PPARα messenger RNA and peroxisome proliferator response element binding in hepatocytes independent of CCR2. Conclusion: Deficiency of MCP-1 protects mice against alcoholic liver injury, independent of CCR2, by inhibition of proinflammatory cytokines and induction of genes related to fatty acid oxidation, linking chemokines to hepatic lipid metabolism. (Hepatology 2011)
210. Intracellular Disassembly and Transcription Efficiency of Polyplexes Delivered into Cells Using Novel Self-Assembling Gene Carriers
Authors: Tetsuji Yamaoka, Tomoko Hashimoto, Tatsuya Kitagawa, Akira Murakami
Journal: Molecular Therapy (2005)

Various nonviral gene vectors, which simultaneously form polyplexes with DNA through electrostatic interaction, have been proposed so far. The mechanism of the polyplex-mediated gene transfer is thought to follow the general endocytotic process. Therefore, many researches have been focusing on each step during the intracellular trafficking to improve their efficiencies. For example, (1) interaction with plasma membrane, (2) internalization into the cells, (3) escape from the endosome, and (4) trafficking to nuclei have been widely studied. We have recently established some systems, with which introduced polyplexes were efficiently delivered into nuclei. Even in these systems, some non-viral carriers were found to lead to high gene transfection and the others could not. According to this finding, we focused on the last step following nuclear localization, that is, disassembly of the complexes and DNA recognition by the transcription factors.