tbuckley/cabot-search huggingface dataset:
Shortage of emergency doctors will take eight years to rectify
Authors: Geoff Watts
Journal: BMJ (2004)

More than 96% of patients now spend fewer than four hours in accident and emergency departments, says an interim report, on progress in reforming NHS emergency care. In a briefing held earlier this week, Professor George Alberti, national director for emergency access, added that the figure will reach 98% by the end of the year.

Central to this achievement, he said, had been the collection of better information about the causes of waiting times—specifically, shortages of beds and specialists, and delays in diagnostic testing. Tackling these should bring still more improvements.

The present strategy was …
Employers cannot increase sanctions against doctors if they appeal, High Court rules
Authors: Clare Dyer
Journal: BMJ (2013)

A consultant obstetrician and gynaecologist has won a High Court ruling that an employer’s disciplinary panel has no power to decide that she be sacked after she appealed against a lesser sanction.

The original panel convened by Airedale NHS Foundation Trust decided that Elizabeth McMillan should be given a final written warning after holding that she had given conflicting accounts of a serious untoward incident.

But she withdrew her appeal and took the case to the High Court after learning that the trust planned to ask the panel that had heard the appeal for a decision that she be dismissed instead.

The trust argued that the …
Plasma α-melanocyte-stimulating hormone, β-endorphin, met-enkephalin, and natural killer cell activity in vitiligo
Authors: Nino Mozzanica, Maria L. Villa, Sergio Foppa, Giulio Vignati, Angelo Cattaneo, Roberto Diotti, Aldo F. Finzi
Journal: Journal of the American Academy of Dermatology (1992)
Eyesight standard for driving.
Authors: A E Wilson
Journal: BMJ (1978)

consider, however, that the risks of lactic acidosis make the use of phenformin undesirable.Stanozolol on the other hand has been shown to be effective when given alone for periods up to 30 months and it is relatively free from side effects.8We should like to suggest that stanozolol is effective in reversing the deficiency of fibrinolysis found in Behqet's disease and that it deserves further consideration as long-term therapy to prevent the development of potentially serious thrombotic episodes in patients with this condition.
Treatment of Sulfur Dioxide Poisoning
Authors: Alvan L. Barach
Journal: JAMA (1971)

To the Editor.—   neglect of treatment of sulfur dioxide poisoning in the hospital as well as in the home is illustrated in the paper by Carnow et al, The Role of Air Pollution in Chronic Obstructive Pulmonary Disease ( 214: 894,1970).   patient in whom acute dyspnea was induced as a result of exposure to sulfur dioxide levels above 0.7 ppm was subjected to an air pollution episode that lasted for two days. However, this serious exposure to the irritant gas could have been terminated almost instantly by employing a spray of 2% sodium bicarbonate; 7 cc of a 1.5% solution of sodium bicarbonate would neutralize 1 ppm of sulfur dioxide in a room of 1,000 cu ft. 1 I might mention that a 2% sodium bicarbonate has been inhaled by patients with no side effects, since this concentration is used in the 2% sodium bicarbonate, 5% glycerine (Alevaire) solution.
Analytic considerations for measuring environmental chemicals in breast milk.
Authors: Larry L Needham, Richard Y Wang
Journal: Environmental Health Perspectives (2002)

The presence of environmental chemicals in human breast milk is of general concern because of the potential health consequence of these chemicals to the breast-fed infant and the mother. In addition to the mother's exposure, several features determine the presence of environmental chemicals in breast milk and their ability to be determined analytically. These include maternal factors and properties of the environmental chemical--both physical and chemical--such as its lipid solubility, degree of ionization, and molecular weight. Environmental chemicals with high lipid solubility are likely to be found in breast milk; they include polyhalogenated compounds such as polychlorinated biphenyls, polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, organochlorine insecticides, and polybrominated diphenylethers. These fat-soluble chemicals are incorporated into the milk as it is synthesized, and they must be measured in accordance with the fat content of the milk to allow for meaningful comparisons within an individual and among populations. Although the analytic approach selected to measure the environmental chemical is predominantly determined by the characteristics of the chemical, the concentration of the chemical in the milk sample and the existence of structurally similar chemicals (e.g., congeners) must be considered as well. In general, the analytic approach for measuring environmental chemicals in breast milk is similar to the approach for measuring the same chemicals in other matrices, except special considerations must be given for the relatively high fat content of milk. The continued efforts of environmental scientists to measure environmental chemicals in breast milk is important for defining the true contribution of these chemicals to public health, especially to the health of the newborn. Work is needed for identifying and quantifying additional environmental chemicals in breast milk from the general population and for developing analytic methods that have increased sensitivity and the ability to speciate various chemicals.
Comparison Between Esophageal Wallstent and Ultraflex Stents in the Treatment of Malignant Stenoses of the Esophagus and Cardia
Authors: G. Dorta, J. Binek, A. L. Blum, H. Bühler, C. P. Felley, H. R. Koelz, F. Lammer, C. Lang, R. Meier, C. Meyenberger, B. Meyer-Wyss, P. Michetti, P. Protiva, U Scheurer, B. Weber, P. Wiesel, S. Vogel
Journal: Endoscopy (1997)

Several published studies have examined various self-expanding metal esophageal stents for use in the palliative treatment of esophageal or cardiac neoplasia, but few have compared different self-expanding metal stents. The aim of this study was to evaluate non-covered Wallstent and Ultraflex prostheses in the treatment of malignancies in the esophagus and the cardiac region.In a retrospective study, the effectiveness of non-covered Wallstents (46 patients) and Ultraflex stents (36 patients) was compared in the treatment of malignancies in the esophageal and cardiac regions.Reintervention procedures were necessary in 16 of the 46 Wallstent patients (six patients during an early phase) and in 22 of the 36 Ultraflex patients (13 during an early phase) (overall P = 0.022; early P = 0.018). The major complication in the Wallstent group was tumor ingrowth (12 of 35 complications), while in the Ultraflex group, it was incomplete deployment (18 of 49 complications). Incomplete stent deployment occurred more often in patients treated with Ultraflex (P = 0.01), and food impaction was more often observed in the Wallstent group (P = 0.001). In addition, in patients with Ultraflex stents, more complex reinterventions were necessary than those required with Wallstents (four vs. 13 complex reinterventions, P = 0.0046). Wallstents tended to improve dysphagia better than Ultraflex stents.Compared to Ultraflex stents, Wallstents have several significant short-term and long-term advantages in the palliative treatment of malignancy of the esophagus and cardia.
Central Nervous System Imprinting of the G Protein Gsα and Its Role in Metabolic Regulation
Authors: Min Chen, Jie Wang, Kathryn E. Dickerson, James Kelleher, Tao Xie, Divakar Gupta, Edwin W. Lai, Karel Pacak, Oksana Gavrilova, Lee S. Weinstein
Journal: Cell Metabolism (2009)
Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases.
Authors: P E Arkkila, I M Kantola, J S Viikari, T Ronnemaa
Journal: Annals of the Rheumatic Diseases (1996)

To examine the association between shoulder capsulitis and chronic diabetic complications and diseases closely related to diabetes.A cross sectional study in 291 type I [mean (SD) age 33.2 (9.9) years] and 134 type II [61.1 (12.4) years] diabetic patients. The presence of shoulder capsulitis, Dupuytren disease, and limited joint mobility was sought. The patients were assessed for background and proliferative retinopathy, nephropathy, autonomic neuropathy, and peripheral symmetrical somatic polyneuropathy. Diseases closely related to diabetes (hypertension, history of myocardial infarction, coronary heart disease, and peripheral vascular disease) were also recorded.Prevalence of shoulder capsulitis was 10.3% in type I and 22.4% in type II diabetic subjects. Shoulder capsulitis was associated with the age in types I (P < 0.01) and II (P < 0.05) diabetic patients, and with the duration of diabetes in type I patients (P < 0.01). Odds ratios for autonomic neuropathy in type I and type II diabetic subjects with shoulder capsulitis were 4.1 (95% confidence interval, 1.6 to 10.9) and 2.7 (95% CI, 1.1 to 7.0), respectively, after controlling for age and duration of diabetes. Odds ratio for history of myocardial infarction in type I diabetic subjects with shoulder capsulitis was 13.7 (95% CI, 1.3 to 139.5) after controlling for age, duration of diabetes, hypertension, and smoking habits. Other associations between shoulder capsulitis and diabetic complications, related diseases, and other hand abnormalities were fully explained by age and the duration of diabetes.Shoulder capsulitis is common in type I and type II diabetic patients. It is associated with age in type I and II diabetic patients and with the duration of diabetes in type I patients. It is associated with autonomic neuropathy in type I and II diabetic patients and with history of myocardial infarction in type I diabetic patients, independently of time related variables.
Pheochromocytoma of the Urinary Bladder
Authors: Isadore J. Zimmerman, Robert E. Biron, H. Edward MacMahon
Journal: New England Journal of Medicine (1953)

APHEOCHROMOCYTOMA of the urinary bladder, to our knowledge, has not previously been reported. The discovery of this tumor in the bladder is of interest not only as a medical curiosity but also as an observation of general academic as well as clinical significance, for the finding is evidence that chromaffin tissue can occur in that organ.Case ReportA 74-year-old woman entered the hospital on March 24, 1950, because on two occasions she had noticed blood in the urine unaccompanied by pain. Except for measles 15 years previously, she had always been well.The past history disclosed no complaints except . . .
Congestive gastropathy in cirrhosis—How bad is red? D'Amico G, Montalbano L, Traina M, Pisa R, Menozzi M, Spano C, Pagliaro L, et al. Natural history of congestive gastropathy in cirrhosis. Gastroenterology 1990;99:1558–1564
Authors: M Blackstone
Journal: Hepatology (1991)
Coronary artery disease varies seasonably in subtropics
Authors: C. Wong, S Ma, T. Lam, A. Hedley
Journal: BMJ (1999)

EDITOR—Seto et al's findings of seasonal variation in mortality from coronary artery disease in Hawaii1 are similar to our own findings in Hong Kong, a subtropical city.

Hong Kong has 6.2 million people residing and working in an urban and suburban area of about 1070 km2. In summer and autumn (May-October) the temperature is warm (mean 27°C; range 22-30°C); in winter and spring (November-April) it is an average of 8°C cooler (19°C; 7-27°C).

As a single disease …
Treatment of seasonal allergic rhinitis with fluticasone propionate aqueous nasal spray: review of comparator studies
Authors: W.W. Storms
Journal: Allergy (1995)

Studies have been conducted in the USA comparing fluticasone propionate aqueous nasal spray 200 micrograms once daily with beclomethasone dipropionate aqueous nasal spray 168 micrograms twice daily, oral terfenadine 60 mg twice daily, or oral astemizole 10 mg once daily given for 2 or 4 weeks during tree, grass or ragweed pollen seasons. All six were multicentre, randomised, placebo-controlled, double-blind, parallel-group studies. Efficacy was evaluated by patient and clinician assessments of individual nasal symptoms and overall response to therapy. Fluticasone propionate was superior to beclomethasone dipropionate in one trial according to patient evaluations of symptoms, but response to fluticasone propionate and beclomethasone dipropionate was similar in the second study. Comparisons with antihistamines showed fluticasone propionate to have greater efficacy. It was more effective than terfenadine in both trials according to evaluations by clinicians and patients. Similar findings were observed in the first astemizole trial. The second astemizole study showed superiority of fluticasone propionate over astemizole in terms of patient and clinician evaluations of overall response to therapy and occasionally in terms of symptom evaluations. There were no significant adverse effects, including effects on plasma cortisol concentrations, noted in any of these comparator studies.
Report calls for new body to evaluate genetic tests
Authors: J. Wise
Journal: BMJ (2010)

The UK government needs urgently to set up mechanisms to evaluate genetic tests, concludes a new independent report. Tests for single gene disorders, such as Huntington’s disease, were likely to prove more useful than tests for common, complex diseases such as cancer and diabetes, it says.

The report by the PHG (Public Health Genetics) Foundation, a think tank on genetics policy, and the Centre for Science and Policy at the University of Cambridge says that a clear process is needed for generating and evaluating data on the clinical and cost effectiveness of new and existing genetic tests so that the NHS can make evidence based decisions on their implementation.

Ron Zimmern, chairman of the PHG Foundation and coauthor of the …
Xenografts of highly resistant leukemia recapitulate the clonal composition of the leukemogenic compartment
Authors: Maike Schmitz, Petra Breithaupt, Nastassja Scheidegger, Gunnar Cario, Laura Bonapace, Barbara Meissner, Paulina Mirkowska, Joelle Tchinda, Felix K. Niggli, Martin Stanulla, Martin Schrappe, Andre Schrauder, Beat C. Bornhauser, Jean-Pierre Bourquin
Journal: Blood (2011)
Withholding and Withdrawal of Life-Sustaining Treatments in Intensive Care Units in Asia
Authors: Jason Phua, Gavin M. Joynt, Masaji Nishimura, Yiyun Deng, Sheila Nainan Myatra, Yiong Huak Chan, Nguyen Gia Binh, Cheng Cheng Tan, Mohammad Omar Faruq, Yaseen M. Arabi, Bambang Wahjuprajitno, Shih-Feng Liu, Seyed Mohammad Reza Hashemian, Waqar Kashif, Dusit Staworn, Jose Emmanuel Palo, Younsuck Koh
Journal: JAMA Internal Medicine (2015)

Little data exist on end-of-life care practices in intensive care units (ICUs) in Asia.To describe physicians' attitudes toward withholding and withdrawal of life-sustaining treatments in end-of-life care and to evaluate factors associated with observed attitudes.Self-administered structured and scenario-based survey conducted among 1465 physicians (response rate, 59.6%) who manage patients in ICUs (May-December 2012) at 466 ICUs (response rate, 59.4%) in 16 Asian countries and regions.For patients with no real chance of recovering a meaningful life, 1029 respondents (70.2%) reported almost always or often withholding whereas 303 (20.7%) reported almost always or often withdrawing life-sustaining treatments; 1092 respondents (74.5%) deemed withholding and withdrawal ethically different. The majority of respondents reported that vasopressors, hemodialysis, and antibiotics could usually be withheld or withdrawn in end-of-life care, but not enteral feeding, intravenous fluids, and oral suctioning. For severe hypoxic-ischemic encephalopathy after cardiac arrest, 1201 respondents (82.0% [range between countries, 48.4%-100%]) would implement do-not-resuscitate orders, but 788 (53.8% [range, 6.1%-87.2%]) would maintain mechanical ventilation and start antibiotics and vasopressors if indicated. On multivariable analysis, refusal to implement do-not-resuscitate orders was more likely with physicians who did not value families' or surrogates' requests (adjusted odds ratio [AOR], 1.67 [95% CI, 1.16-2.40]; P = .006), who were uncomfortable discussing end-of-life care (AOR, 2.38 [95% CI, 1.62-3.51]; P < .001), who perceived greater legal risk (AOR, 1.92 [95% CI, 1.26-2.94]; P = .002), and in low- to middle-income economies (AOR, 2.73 [95% CI, 1.56-4.76]; P < .001). Nonimplementation was less likely with physicians of Protestant (AOR, 0.36 [95% CI, 0.16-0.80]; P = .01) and Catholic (AOR, 0.22 [95% CI, 0.09-0.58]; P = .002) faiths, and when out-of-pocket health care expenditure increased (AOR, 0.98 per percentage of total health care expenditure [95% CI, 0.97-0.99]; P = .02).Whereas physicians in ICUs in Asia reported that they often withheld but seldom withdrew life-sustaining treatments at the end of life, attitudes and practice varied widely across countries and regions. Multiple factors related to country or region, including economic, cultural, religious, and legal differences, as well as personal attitudes, were associated with these variations. Initiatives to improve end-of-life care in Asia must begin with a thorough understanding of these factors.
27 USE OF STEROIDS AFTER LIVER TRANSPLANTATION IS ASSOCIATED WITH LOWER RISK OF EARLY GRAFT FAILURE (EGF): INSIGHTS FROM THE LIVER MATCH PROSPECTIVE STUDY
Authors: M. Angelico, T. Marianelli, U. Cillo, A. Nardi, R. Romagnoli, A. Ricci, P. Toniutto, M. Strazzabosco
Journal: Journal of Hepatology (2010)
Biochemical Efficacy and Safety of Monthly Augmentation Therapy for α1-Antitrypsin Deficiency
Authors: R. C. Hubbard
Journal: JAMA (1988)

The hereditary disorder α1-antitrypsin (α1AT) deficiency results in the development of emphysema due to a diminished anti—neutrophil elastase screen of the lower respiratory tract. Specific therapy for this disorder is available in the form of weekly intravenous infusions of human plasma α1AT, which effectively reconstitute the anti-elastase screen of the lung in these individuals. In an attempt to reduce the frequency of therapy we evaluated the ability of monthly infusions of α1AT to provide equivalent lower respiratory tract protection against neutrophil elastase. Intravenous infusion of 250 mg/kg of α1AT at 28-day intervals to nine individuals with α1AT deficiency and emphysema was carried out for 12 months. Serum α1AT levels exceeded the protective threshold for an average of 25 days after each dose of α1AT was administered. Furthermore, the postinfusion level of α1AT in the nadir lung epithelial lining fluid was fivefold greater than the preinfusion level, and the anti—neutrophil elastase capacity of the nadir epithelial lining fluid also was elevated significantly, nearly threefold above the preinfusion level. These results indicate that monthly administration of human α1AT is fully capable of adequately augmenting serum and lung α1AT levels and anti-elastase capacity and is therefore a rational alternative to weekly therapy. (<i>JAMA</i>1988;260:1259-1264)
Cortical and Subcortical Patterns of I-123 Iodobenzamide SPECT in Striatal D2 Receptor Parkinsonisms
Authors: Paloma Pifarré, Gemma Cuberas, Jorge Hernández, Carles Lorenzo, Francesc Miquel, Joan Castell-Conesa
Journal: Clinical Nuclear Medicine (2010)

The D(2) receptor is the most widely expressed dopaminergic receptor in the central nervous system, and it is present at the pre- and postsynaptic dopaminergic regions. It is mainly located in the neostriatum as well as in the globus pallidus, substantia nigra, cerebral cortex, thalamus, etc. The objective of this study was to analyze qualitatively and quantitatively the distribution pattern of the postsynaptic dopamine receptors through SPECT with iodobenzamide (IBZM) in patients with parkinsonism and to determine the benefit of this imaging technique in the differential diagnosis of the parkinsonian syndromes.A total of 26 patients with clinical and imaging (Iodine-123 fluoropropyl-carbomethoxy-3 beta-(4-iodophenyltropane) [FP-CIT]) diagnostics of parkinsonism, to all of which a study of postsynaptic D(2) receptors with IBZM was made, were retrospectively reviewed. Of total, 12 patients were male (42.85%). The average age was 73 years old (range, 64-83 years). The patients were imaged using SPECT 2 hours after administration of I-123 Iolopride (IBZM) and their images were evaluated qualitatively and quantitatively. To measure the relative density of the D(2) receptors, the studies were registered to a common space in which the structures to be analyzed were delimited over a RM template. Caudate/frontal (C/FI) and putamen/frontal (P/FI) activity indexes were obtained.Of total, 10 patients presented normal IBZM uptake (C/FI of 1.23 + or - 0.13; P/FI of 1.53 + or - 0.11). The 16 studies listed as abnormal were divided into 2 degrees: (I) appearance of thalamic activity with preserved striatal uptake and (II) thalamus and frontal increased uptake with decrease of striatal activity. In the patients with abnormal patterns, the region that showed a greater reduction of uptake was the putamen (P/FI of 1.1 + or - 0.07 for degree 1, P < 0.05 and P/FI of 1.25 + or - 0.19 for degree 2, P < 0.001). For the differential diagnosis of Parkinson disease in relation to the atypical parkinsonisms, the sensitivity was 68.4% (confidence interval, 51.9-87.6) and the specificity was 57.1% (confidence interval, 20.2-88.2). The patients with Parkinson disease with longer evolution times showed a decrease of D(2) activity (3/7).The appearance of thalamic activity may be an early indicator of a decrease of D(2) striatal receptors in atypical parkinsonisms and in patients with long-term Parkinson disease.
Protein Expression Profiles in Pancreatic Adenocarcinoma Compared with Normal Pancreatic Tissue and Tissue Affected by Pancreatitis as Detected by Two-Dimensional Gel Electrophoresis and Mass Spectrometry
Authors: Jianjun Shen, Maria D. Person, Jijiang Zhu, James L. Abbruzzese, Donghui Li
Journal: Cancer Research (2004)

Abstract Pancreatic cancer is a rapidly fatal disease, and there is an urgent need for early detection markers and novel therapeutic targets. The current study has used a proteomic approach of two-dimensional (2D) gel electrophoresis and mass spectrometry (MS) to identify differentially expressed proteins in six cases of pancreatic adenocarcinoma, two normal adjacent tissues, seven cases of pancreatitis, and six normal pancreatic tissues. Protein extracts of individual sample and pooled samples of each type of tissues were separated on 2D gels using two different pH ranges. Differentially expressed protein spots were in-gel digested and identified by MS. Forty proteins were identified, of which five [i.e., α-amylase; copper zinc superoxide dismutase; protein disulfide isomerase, pancreatic; tropomyosin 2 (TM2); and galectin-1] had been associated previously with pancreatic disease in gene expression studies. The identified proteins include antioxidant enzymes, chaperones and/or chaperone-like proteins, calcium-binding proteins, proteases, signal transduction proteins, and extracellular matrix proteins. Among these proteins, annexin A4, cyclophilin A, cathepsin D, galectin-1, 14–3-3ζ, α-enolase, peroxiredoxin I, TM2, and S100A8 were specifically overexpressed in tumors compared with normal and pancreatitis tissues. Differential expression of some of the identified proteins was further confirmed by Western blot analyses and/or immunohistochemical analysis. These results show the value of a proteomic approach in identifying potential markers for early diagnosis and therapeutic manipulation. The newly identified proteins in pancreatic tumors may eventually serve as diagnostic markers or therapeutic targets.