tbuckley/cabot-search huggingface dataset:
People with learning difficulties face abuse in health settings
Authors: Paul Stephenson
Journal: BMJ (2008)

Health trusts and local authorities in the United Kingdom have a duty to promote respect for human rights to help stop the neglect and abuse of adults with learning disabilities, a parliamentary committee report says.

The report, on the rights of adults with learning disabilities by the Joint Committee on Human Rights, found that public bodies are not fully committed to implementing government policy on rights, independence, choice, and inclusion. It also says that limited resources are undermining attempts to implement the policy.

The committee heard evidence that people with learning disabilities …
Psoriasis and the Risk of Diabetes Mellitus
Authors: April W. Armstrong, Caitlin T. Harskamp, Ehrin J. Armstrong
Journal: JAMA Dermatology (2012)

To compare the prevalence and incidence of type 2 diabetes mellitus between patients with psoriasis and those without psoriasis.MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews between January 1, 1980, and January 1, 2012.Observational (cohort, case-control, and cross-sectional) studies published in English that compared the prevalence or incidence of diabetes among patients with psoriasis with individuals serving as controls.Two independent investigators extracted the data. The quality of evidence was assessed using a 6-point scale.Among 142 identified publications, 27 observational studies were included in the meta-analysis. Five of these studies assessed the incidence of diabetes in patients with psoriasis and were analyzed separately. Among studies assessing the prevalence, psoriasis was associated with an odds ratio (OR) of 1.59 (95% CI, 1.38-1.83) for diabetes. The pooled OR was 1.53 (95% CI, 1.16-2.04) for mild psoriasis and 1.97 (1.48-2.62) for severe psoriasis. Meta-regression of prespecified potential sources of heterogeneity revealed a nonsignificant difference (P= .10) of increased reported strength of association among studies that used medical record review (OR, 1.52 [95% CI, 1.31-1.77]) or patients' report of diabetes (2.79 [1.42-5.48]) compared with studies that used billing data (1.46 [1.01-2.09]). Among studies that assessed incidence, psoriasis was associated with a relative risk of 1.27 (95% CI, 1.16-1.40) for developing diabetes.Psoriasis is associated with an increased prevalence and incidence of diabetes. The association of psoriasis with diabetes may be strongest among patients with severe psoriasis.
"Dangerous" locum surgeon is struck off medical register
Authors: C. Dyer
Journal: BMJ (2011)

A “dangerous” surgeon who held 14 locum posts in one year, not one of which was renewed, has been struck off by the UK General Medical Council with immediate effect.

Lucius Okere’s practice was “of an appallingly low standard; was seriously lacking, even with respect to basic medical and surgical skills and procedures; and was not only incompetent, but dangerous,” a GMC fitness to practise panel decided.

Dr Okere, 53, who was originally from Nigeria but …
Right Bundle-Branch Block and Prognosis
Authors: Allen D. Meisel, Eric C. Rackow
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 April 1973Right Bundle-Branch Block and PrognosisALLEN D. MEISEL, M.D., ERIC C. RACKOW, M.D.ALLEN D. MEISEL, M.D.Search for more papers by this author, ERIC C. RACKOW, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-4-618_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The Coronary Drug Project Research Group paper (1) deserves comment on the statement that complete right bundle-branch block in a postinfarction ECG has no significant prognostic value. The concept that right bundle-branch block is a benign conduction disturbance with no appreciable mortality seems no longer tenable. In a review of 480 cases of acute myocardial infarction Scheinman and Brenman (2) found that 3.7% had right bundle-branch block with a normal QRS axis. Norris, Mercer, and Croxson (3) report the cumulative incidence of isolated right bundle-branch block as 2.1% for 1440 cases of anteroseptal myocardial infarction. Table 1...References1. : The prognostic importance of the electrocardiogram after myocardial infarction. Ann Intern Med 77:677-689, 1972 LinkGoogle Scholar2. SCHEINMAN M and BRENMAN B: Clinical and anatomic implications of intraventricular conduction blocks in acute myocardial infarction. Circulation 46:753-760, 1972 CrossrefMedlineGoogle Scholar3. NORRIS R, MERCER C, and CROXSON M: Conduction disturbances due to anteroseptal myocardial infarction and their treatment by endocardial pacing. Am Heart J 84:560-566, 1972 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ALLEN D. MEISEL, M.D.; ERIC C. RACKOW, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1973Volume 78, Issue 4 Page: 618-618 Keywords Acute myocardial infarction Drug research and development Drugs Mortality Myocardial infarction Right bundle branch block ePublished: 1 December 2008 Issue Published: 1 April 1973 PDF downloadLoading ...
Non-accidental poisoning and child abuse
Authors: J. P Osborne
Journal: BMJ (1976)

was examined and found to contain amitriptyline three days after admission.The following day the mother was caught in the act of giving the child amitriptyline from a feeding beaker.It was later discovered that a sibling who had died at five months within 24 hours of discharge from a peripheral hospital had at necropsy an unexplained fracture of one humerus and a torn lingual fraenum.
Case of Traumatic Subcutaneous Rupture of the Abdominal Wall
Authors: A. J. Dougall
Journal: BMJ (1966)

BanIBsH(and also female deaths from benign tumours) were anomalous in being considerably less frequent in spring (March-April-May) than in autumn (September-October-November).And Table III shows that this anomaly was characteristic, though unequally so, of most of the individual cancer sites.Of the very few non-neoplastic diseases which were similarly anomalous in England and Wales in 1956-633 the two with the lowest ratio of spring to autumn deaths were simple goitre, namely 0.72 (33:46), and avitaminoses (in females), namely 0.76 (121:160).In contrast, the corresponding ratio at the other extreme for thyrotoxicosis, namely 1.35 (750: 554), and for non-toxic nodular goitre, namely 1.41 (55: 39).This last was next highest to the ratio for respiratory diseases, namely 1.43 (140,512:97,999).Gereb2 found that cancer deaths were least frequent in March and April, and as a possible explanation of this he suggested vitamin lack, citing experimental evidence of the inhibiting effect of vitamin lack on tumour growth, and also evidence, consistent with this, of seasonal variation in tumour growth.Speculation as to causes, however, is likely to be unfruitful until at the least a much more extensive and sophisticated analysis has been made, not only of British and German data but also of corresponding data from other latitudes and longitudes.-Iam, etc.,.
Aurora kinase A-specific T-cell receptor gene transfer redirects T lymphocytes to display effective antileukemia reactivity
Authors: Kozo Nagai, Toshiki Ochi, Hiroshi Fujiwara, Jun An, Toshiaki Shirakata, Junichi Mineno, Kiyotaka Kuzushima, Hiroshi Shiku, J. Joseph Melenhorst, Emma Gostick, David A. Price, Eiichi Ishii, Masaki Yasukawa
Journal: Blood (2011)
Active Idiotypic Vaccination Versus Control Immunotherapy for Follicular Lymphoma
Authors: Ronald Levy, Kristen N. Ganjoo, John P. Leonard, Julie M. Vose, Ian W. Flinn, Richard F. Ambinder, Joseph M. Connors, Neil L. Berinstein, Andrew R. Belch, Nancy L. Bartlett, Craig Nichols, Christos E. Emmanouilides, John M. Timmerman, Stephanie A. Gregory, Brian K. Link, David J. Inwards, Arnold S. Freedman, Jeffrey V. Matous, Michael J. Robertson, Lori A. Kunkel, Diane E. Ingolia, Andrew J. Gentles, Chih Long Liu, Robert Tibshirani, Ash A. Alizadeh, Dan W. Denney
Journal: Journal of Clinical Oncology (2014)

Idiotypes (Ids), the unique portions of tumor immunoglobulins, can serve as targets for passive and active immunotherapies for lymphoma. We performed a multicenter, randomized trial comparing a specific vaccine (MyVax), comprising Id chemically coupled to keyhole limpet hemocyanin (KLH) plus granulocyte macrophage colony-stimulating factor (GM-CSF) to a control immunotherapy with KLH plus GM-CSF.
The Thyroid Nodule
Authors: JOHN L. STOCK
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 June 1982The Thyroid NoduleJOHN L. STOCK, M.D., NORIO HIGANO, M.D.JOHN L. STOCK, M.D.Search for more papers by this author, NORIO HIGANO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-96-6-784_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We suggest an alternative to the methods discussed by Van Herle and associates (1) for evaluating the thyroid nodule. After being screened with radionuclide scans, 34 patients with discrete cold nodules had fine needle aspiration of these nodules and a simultaneous ultrasound examination. Appropriate sweeps with the transducer of our static B-mode ultrasound equipment during the aspiration have enabled us to both identify cystic areas and improve biopsy accuracy by confirming the needle's position while in the nodule. Even in patients with solid nodules, we have found subtle differences in tissue density and have improved localization of...Reference1. VAN HERLERICHLJUNGASHCRAFTSOLOMONKELLER APBMDE. The thyroid nodule. Ann Intern Med. 1982;96: 221-32. LinkGoogle Scholar1. VAN HERLERICHLJUNGASHCRAFTSOLOMONKEELER APBMDE. The thyroid nodule. Ann Intern Med. 1982;96: 221-32. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Memorial Hospital The University of Massachusetts Medical School Worcester, MA 01605 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1982Volume 96, Issue 6_Part_1Page: 784-785KeywordsBiopsyThyroidUltrasound imaging Issue Published: 1 June 1982 PDF downloadLoading ...
AIDS and the lung: update 1995. 3. Intrathoracic Kaposi's sarcoma in patients with AIDS.
Authors: J Cadranel, C Mayaud
Journal: Thorax (1995)

In early 1981 the acquired immunodeficiency syndrome (AIDS) was initially recognised from the outbreak of Kaposi's sarcoma and Pneu- mocystis carinii pneumonia among young, previously healthy homosexual men. 2 The incidence of Kaposi's sarcoma as an in- augurating event has decreased regularly since the mid 1980s from between 35-40% to less than 15% of all cases of AIDS presently re- ported in Europe and the USA'3 4; Kaposi's sarcoma, however, still remains the most fre- quent cause of pulmonary localisation of AIDS associated malignancies, and the prognosis of Kaposi's sarcoma is related in part to visceral involvement, particularly the lung.'2 5 Although our knowledge of this disease remains in- complete, several recent studies have con- siderably advanced our understanding of the pathogenesis, diagnosis and, to a lesser extent, the treatment of Kaposi's sarcoma, particularly in cases of visceral involvement.L6 The pur- pose of this review is threefold: firstly, to sum- marise recent advances concerning the pathogenesis of Kaposi's sarcoma; secondly, to review briefly the pathological and clinical features of the disease; and finally, to describe current approaches to its diagnosis and treat- ment.Although all forms are discussed, this review will concentrate on intrathoracic Kaposi's sarcoma.There are a number of recent reviews available which emphasise other as- pects of the disease.3 46Pathogenesis of Kaposi's sarcoma: an unresolved debate The use of new technology in investigating the cellular and molecular changes has resulted in better understanding of the pathogenesis of Kaposi's sarcoma, but numerous questions remain unanswered.
Acute hibernation and reperfusion of the ischemic heart.
Authors: S E Downing, V Chen
Journal: Circulation (1992)

BACKGROUND Recovery from prolonged low-flow ischemia was studied in isolated, isovolumically beating neonatal piglet hearts (n = 11) and compared with controls (n = 5). METHODS AND RESULTS Hearts were perfused with red blood cell-enhanced Krebs-Henseleit buffer with physiological oxygen-carrying capacity. Left ventricular mechanical function was assessed with a fluid-filled balloon. Measurements of peak systolic pressure, pressure-rate product (PRP), and +dP/dtmax were obtained at various filling pressures. Myocardial oxygen delivery and metabolism (MVO2) and lactate uptake were measured at 30-minute intervals. Control data were obtained with coronary flow (CF) set at 2 ml.min-1.g-1. CF was then reduced to 0.2 ml.min-1.g-1 for 2 hours. Thereafter, reperfusion was instituted at control levels. Hearts not subjected to ischemia were studied at identical time intervals. In these, function remained at greater than 80% after more than 3.5 hours of study. Reduction of CF to 10% was accompanied by an abrupt diminution in function (pressure-rate product) and MVO2 to 20% of control and by lactate release. These measures remained constant for the full 2 hours of ischemia. Incremental return of CF caused a lockstep increase in mechanical function and metabolism. At 30 minutes of reperfusion, PRP was 78% of time-matched controls (p = 0.05), and dP/dtmax did not differ. Increasing calcium to 5 mmol/l returned PRP (and dP/dtmax) to preischemia levels. Myocardial ATP and creatine phosphate concentrations were identical in both groups, although glycogen was lower in the ischemic hearts. CONCLUSIONS Acute hibernation is associated with protection of the in vitro heart from prolonged normothermic ischemia. Systolic function was only modestly lower, and velocity (dP/dtmax) did not differ from control hearts. The minimal "stunning" was fully reversible with calcium.
Letter by Alla et al Regarding Article, “Duration of Treatment With Nonsteroidal Anti-Inflammatory Drugs and Impact on Risk of Death and Recurrent Myocardial Infarction in Patients With Prior Myocardial Infarction: A Nationwide Cohort Study”
Authors: Venkata M. Alla, Swapna Kanuri, Dennis Esterbrooks
Journal: Circulation (2011)
Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats
Authors: C. C Butler, S. Rollnick, R. Pill, F. Maggs-Rapport, N. Stott
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objectives:</b> To better understand reasons for antibiotics being prescribed for sore throats despite well known evidence that they are generally of little help. <b>Design:</b> Qualitative study with semi-structured interviews. <b>Setting:</b> General practices in South Wales. <b>Subjects:</b> 21 general practitioners and 17 of their patients who had recently consulted for a sore throat or upper respiratory tract infection. <b>Main outcome measures:</b> Subjects9 experience of management of the illness, patients9 expectations, beliefs about antibiotic treatment for sore throats, and ideas for reducing prescribing. <b>Results:</b> Doctors knew of the evidence for marginal effectiveness yet often prescribed for good relationships with patients. Possible patient benefit outweighed theoretical community risk from resistant bacteria. Most doctors found prescribing “against the evidence” uncomfortable and realised this probably increased workload. Explanations of the distinction between virus and bacterium often led to perceived confusion. Clinicians were divided on the value of leaflets and national campaigns, but several favoured patient empowerment for self care by other members of the primary care team. Patient expectations were seldom made explicit, and many were not met. A third of patients had a clear expectation for antibiotics, and mothers were more likely to accept non-antibiotic treatment for their children than for themselves. Satisfaction was not necessarily related to receiving antibiotics, with many seeking reassurance, further information, and pain relief. <b>Conclusions:</b> This prescribing decision is greatly influenced by considerations of the doctor-patient relationship. Consulting strategies that make patient expectations explicit without damaging relationships might reduce unwanted antibiotics. Repeating evidence for lack of effectiveness is unlikely to change doctors9 prescribing, but information about risk to individual patients might. Emphasising positive aspects of non-antibiotic treatment and lack of efficacy in general might be helpful.
Ghrelin promotes thymopoiesis during aging
Authors: Vishwa Deep Dixit, Hyunwon Yang, Yuxiang Sun, Ashani T. Weeraratna, Yun-Hee Youm, Roy G. Smith, Dennis D. Taub
Journal: Journal of Clinical Investigation (2007)

The decline in adaptive immunity, T lymphocyte output, and the contraction of the TCR repertoire with age is largely attributable to thymic involution. The loss of thymic function with age may be due to diminished numbers of progenitors and the loss of critical cytokines and hormones from the thymic microenvironment. We have previously demonstrated that the orexigenic hormone ghrelin is expressed by immune cells and regulates T cell activation and inflammation. Here we report that ghrelin and ghrelin receptor expression within the thymus diminished with progressive aging. Infusion of ghrelin into 14-month-old mice significantly improved the age-associated changes in thymic architecture and thymocyte numbers, increasing recent thymic emigrants and improving TCR diversity of peripheral T cell subsets. Ghrelin-induced thymopoiesis during aging was associated with enhanced early thymocyte progenitors and bone marrow–derived Lin–Sca1+cKit+ cells, while ghrelin- and growth hormone secretagogue receptor–deficient (GHS-R–deficient) mice displayed enhanced age-associated thymic involution. Leptin also enhanced thymopoiesis in aged but not young mice. Our findings demonstrate what we believe to be a novel role for ghrelin and its receptor in thymic biology and suggest a possible therapeutic benefit of harnessing this pathway in the reconstitution of thymic function in immunocompromised subjects.
Letter from Victoria. Drivers and health.
Authors: J Knight
Journal: BMJ (1976)

If a patient with a central venous catheter develops an unexplained fever then a first axiom is that the catheter should be removed.In surgical patients, however, where other causes of sepsis abound, there is only a 50O( probability that the catheter has caused the fever.'9A systematic approach to each case is needed and can be achieved by using a simple logic chart,'1 which reduces significantly the unneces- sary removal of a vital lifeline. Team approachUndoubtedly the ultimate success of parenteral nutrition depends not only on medical staff but also on nursing staff and pharmacists.Liaison and co-ordination between these groups are vital.There is also the constant problem of staff turnover with new members unfamiliar with established practice.We find that the most successful way of managing this type of nutrition is by having a clearly defined team organised by a single member of the medical staff.The objectives of the team are co- ordination and education with a view to maintaining standards.Regular meetings of the team ensure that even the most trivial prob- lems are adequately discussed.20Furthermore, education in new techniques and modification of existing practices are more swiftly and easily achieved. ConclusionsTo feed a patient by a vein is now technically feasible and often clinically advisable.To do so effectively requires us to bring to prescription, methods, and control standards that are as high as in any other therapeutic field.We have attempted to delineate some of these standards and would emphasise again the need for acquiring skills and placing the technique and patients who require it into the hands of only those who are both interested in the problem and determined to succeed.
Infradiaphragmatic Anomalous Pulmonary Venous Drainage
Authors: W. JEGIER, E. CHARRETTE, A. R. C. DOBELL
Journal: Circulation (1967)

The pathological anatomy and hemodynamic effects of total anomalous pulmonary venous drainage of the infradiaphragmatic type are reviewed in nine infants examined from 1940 to 1965 in the pathology department. Two infants underwent corrective surgery in the period; one operation was unsuccessful. The other infant had normal hemodynamics 6 months postoperatively and continues to do well 2 years after operation. Surgical principles are discussed. Some patients undergoing an anastomosis between the common pulmonary venous trunk and the left atrium will not require a second operation either to ligate the venous trunk or to close the atrial septal defect.
Effects of Antithyroid Drug Therapy on Blood Glucose, Serum Insulin, and Insulin Binding to Red Blood Cells in Hyperthyroid Patients of Different Ages
Authors: Ichiro Komiya, Takashi Yamada, Akira Sato, Yoichi Koizumi, Takeshi Aoki
Journal: Diabetes Care (1985)

The mechanism of glucose intolerance in thyrotoxicosis was investigated in 119 patients with Graves's disease with careful consideration of the age-related deterioration of glucose tolerance. Before and after treatment of thyrotoxicosis with antithyroid drug, changes of blood glucose (BG) and serum immunoreactive insulin (IRI) in response to 50 g oral glucose tolerance test (OGTT) and insulin binding to red blood cell (RBC) were evaluated. In control subjects, the ΣIRI/ΣBG ratio after 50-g OGTT decreased progressively with age without significant change in absolute ΣIRI value, suggesting the occurrence of age-related insulin resistance. Glucose intolerance was much more apparent in hyperthyroid patients because of age-related relative decrease of insulin secretion. Such a decrease of insulin secretion was not found in age-matched postgastrectomy patients with a similar degree of hyperglycemia, however. Maximal binding of labeled insulin and number of insulin receptors of RBC were decreased in old patients but binding affinity was unchanged. Elevation of BG was partially suppressed when serum thyroxine (T4) and triiodothyronine (T3) were reduced to moderately supernormal levels, whereas ΣBG, ΣIRI, ΣIRI/ΣBG ratio, and insulin binding to RBC were all returned to normal when normal serum thyroid hormone concentration was maintained. Our data indicate that insufficient insulin secretion and reduced insulin action at the target cell are responsible, at least in large part, for age-related glucose intolerance in hyperthyroid patients.
Respiratory effects of analgesia after cholecystectomy: comparison of continuous and intermittent papaveretum.
Authors: J A Catling, D M Pinto, C Jordan, J G Jones
Journal: BMJ (1980)

Two methods of administering papaveretum for relieving postoperative pain were compared in two groups of patients who had undergone cholecystectomy. In one group a loading dose of papaveretum was administered by continuous intravenous infusion (1 mg/min) until the patient could breathe deeply without undue pain. Eight times this loading dose was given as a continuous intravenous infusion over the subsequent 48 hours. This regimen was compared with a conventional intermittent intramuscular dose (0.25 mg/kg at four hourly intervals as necessary) in a second group of patients. The intravenous regimen relieved pain better than the intramuscular regimen, which may have reflected the larger dose of papaveretum given to the intravenous group, but it was accompanied by a greater degree of respiratory depression and potentially life-threatening changes in respiratory pattern. These findings suggest that the fear which often accounts for inadequate postoperative pain relief-that larger dose of analgesics will cause respiratory complications-is well founded.