tbuckley/cabot-search huggingface dataset:
Personal medical services: a barometer for the NHS?
Authors: J. Shapiro
Journal: BMJ (2000)

The personal medical services (PMS) pilot scheme in the British NHS has been in existence for over two years and was designed to allow experimental schemes to test alternative models for delivering primary and community care.1 So far the scheme has proved popular, but three new factors make it important to review the future of the scheme and its direction: the New NHS white paper2; the very popularity of the scheme; and the impact of the “NHS plan.”3

Because British general practitioners have traditionally been self employed, the contract under which they perform work for the NHS (the general medical services (GMS) arrangements set out in the “red book”) is elaborate and is perceived as being inflexible and bureaucratic. The personal medical services scheme allowed participants to test contractual mechanisms that would have been illegal under the normal arrangements. Although the personal medical services scheme has sometimes been called the “salaried doctors” scheme (to contrast with the normal self employment arrangements), this has not been its defining characteristic. Rather, the …
The Modern Surgery Department Chairman
Authors: Douglas P. Slakey, James R. Korndorffer, Kira N. Long, Tyler Clark, Marco Hidalgo
Journal: JAMA Surgery (2013)

The role of the chairman of a surgery department is critical in academic surgery. However, little is known about the variability of job responsibilities.To evaluate chairmen's responsibilities, methods of support, determinants of job performance success, and concerns.Internet-based survey.Electronic survey system.Seventy-two chairmen.Survey data on job responsibilities, methods of support, determinants of job performance success, and concerns.Of 168 chairmen who received the survey, 72 (43%) responded. The mean age of chairmen was 57 years (range, 44-78 years). Of 72 chairmen who responded, 69 (96%) were men, 67 (93%) were white, 65 (90%) were professors, 11 (15%) held a previous chair, 35 (49%) have advanced degrees, and 19 (26%) are program directors. Respondents are responsible for an average of 8.7 divisions, 60 (83%) spent 1 to 10 hours per week in the clinic, 45 (63%) performed surgery 1 to 10 hours per week, 54 (75%) took less than 6 call days per month, 44 (61%) published 1 to 6 papers per year and attended a mean (SD) of 4.3 (1.7) essential meetings per year, and 48 (67%) took 1 to 3 weeks of vacation annually. Chair salary support includes (from least to most) faculty tax, grants, endowment, school, and hospital. Compensation correlates with age, additional degree, specialty, location, contract, and tenure but not clinical hours. Reported compensation was consistent with data from the Association of American Medical Colleges, but 24 (33%) felt undercompensated. Incentives for job performance were given for clinical productivity (34 chairmen [47%]), department performance (50 [70%]), institutional performance (27 [38%]), and personal accomplishment (14 [19%]). Of 72 chairmen, 30 (42%) were concerned about personal liability related to the job, 15 (21%) had purchased personal liability insurance, and 20 (28%) have defended a lawsuit related to nonclinical responsibilities.Academic surgery department chairmen have a wide array of responsibilities that have changed from historic standards. Success in the role of chairman may improve by appreciating the responsibilities, time allocation, methods of support, and concerns of other chairmen.
Evaluation of tumour-infiltrating CD4+CD25+FOXP3+ regulatory T cells in human cutaneous benign and atypical naevi, melanomas and melanoma metastases
Authors: V. Mourmouras, M. Fimiani, P. Rubegni, M.C. Epistolato, V. Malagnino, C. Cardone, E. Cosci, M.C. De Nisi, C. Miracco
Journal: British Journal of Dermatology (2007)

Background CD4+CD25+FOXP3+ regulatory T cells (Tregs) are thought to induce immunotolerance in melanoma. They have not yet been investigated in the entire spectrum of melanocytic cutaneous lesions within a tumour site. Objectives To evaluate CD4+CD25+FOXP3+ Tregs among tumour-infiltrating lymphocytes in cutaneous melanocytic lesions. Methods We analysed 128 lesions (10 benign junctional common naevi, 10 benign compound common naevi, 10 compound Spitz naevi, 10 junctional atypical naevi, 20 compound atypical naevi, 20 radial growth phase melanomas, 30 vertical growth phase melanomas and 18 melanoma metastases). Tregs were identified by CD25-FOXP3 double immunostains. Results This study indicates that CD4+/CD25+FOXP3+ Tregs are present in all groups of lesions. Junctional atypical naevi, compound atypical naevi and radial growth phase melanomas showed the highest percentages of CD4+CD25+FOXP3+ Tregs (junctional atypical naevi vs. junctional common naevi, compound common naevi, compound Spitz naevi, melanoma metastases: P < 0·0001; junctional atypical naevi vs. vertical growth phase melanomas: P = 0·001; compound atypical naevi vs. junctional common naevi, compound common naevi: P < 0·0001; compound atypical naevi vs. compound Spitz naevi, melanoma metastases: P = 0·002; compound atypical naevi vs. vertical growth phase melanomas: P = 0·02; radial growth phase melanomas vs. junctional common naevi, compound common naevi, compound Spitz naevi, melanoma metastases: P < 0·0001; radial growth phase melanomas vs. vertical growth phase melanomas: P = 0·008). Conclusions The strong prevalence of CD25+FOXP3+ Tregs both in junctional andcompound atypical naevi and radial growth phase melanomas, suggests that they induce immunotolerance early during melanoma genesis, favouring melanoma growth. Their evaluation within a tumour site could be useful for prognostic and therapeutic purposes.
Responsibilities of sponsors are limited in premature discontinuation of trials
Authors: R. Ashcroft
Journal: BMJ (2001)

EDITOR—The contributions by Lievre et al and Pocock and Evans make important points about the ethical problems surrounding early termination of trials for non-scientific reasons. 1 2 But their argument about the responsibilities of sponsors goes too far.

The Declaration of Helsinki makes it clear that sponsors and investigators do have obligations to the participants enrolled into the trial. These include fair treatment, avoiding exploitation and unnecessary harm, and …
Clinical studies with low‐molecular‐weight heparin(oid)s: An interim analysis
Authors: Hugo Ten Gate, C. Pieter Henny, Jan W. Ten Cate, Harry R. Büller
Journal: American Journal of Hematology (1988)

Abstract In this review an interim analysis was made of all clinical studies performed with low‐molecular‐weight heparin(oid)s (LMWH) up to January 1987. Thus far, many experimental studies on LMWH show these substances to have an increased benefit/risk ratio concerning efficacy and bleeding as compared to standard heparin. In man, this increased ratio was verified in some small open studies. However, until the present day, controversy still exists. Some of the difficulties In assessing the results of different investigations include the existence of various kinds of LMWH and the lack of a consensus as to the unitage in which they are expressed. Furthermore, no international agreement exists as to the test measuring dosage/effect and its standard. In the following review all published clinical studies were analyzed for patient groups. Important issues concerning controversy with regard to efficacy, bleeding risk, diagnosis, and testing are discussed. In general, it may be concluded that LMWH have an antithrombotic potential comparable to that of heparin, and that the benefit/risk ratio I.e., decreased bleeding potential when compared to standard heparin, as found in animal experiments, has not been clearly demonstrated in man.
More than half of infants in developing countries are breast fed for less than six months, report says
Authors: S. Mayor
Journal: BMJ (2011)

More than half of infants born in developing countries each year are being breast fed for less than the recommended six months, warns a new report.

The report investigates breastfeeding practices and infant feeding policies in 33 developing countries taking part in the World Breastfeeding Trend Initiative. This is an ongoing project being run by the International Baby Food Action Network Asia to help countries monitor implementation of measures to achieve the World Health Organization’s recommendations on feeding of infants.

Its results show that only around 36 million of the 78 million infants born each year in the 33 countries surveyed get what is considered the optimal amount of breast feeding. The report defines this as exclusive breast feeding for the …
796. Pol II-Driven shRNA as an Effective Hepatitis B Virus Therapeutic
Authors: Jeffery C. Giering, Dirk Grimm, Theresa A. Storm, Hui Xu, Mark A. Kay
Journal: Molecular Therapy (2006)

The majority of attempts to employ short-hairpin RNA (shRNA) expression vectors as therapeutics to induce the gene-specific silencing effects of RNA interference (RNAi) utilized ubiquitously recognized, highly active pol III promoters like U6 and H1. While silencing efficiency is, at least initially, extremely high, such constructs have the potential to cause serious side effects, resulting either from widespread off-target effects or from saturating the RNAi machinery, which is proving more central to cellular function.
Action Potentials in Chick Atria: INCREASED SUSCEPTIBILITY TO BLOCKADE BY TETRODOTOXIN DURING EMBRYONIC DEVELOPMENT
Authors: Achilles J. Pappano
Journal: Circulation Research (1972)

Tetrodotoxin (TTX) at a concentration of 1.6 x 10 -7 M blocked intracellularly recorded action potentials in 12- and 18-day-old embryonic chick atria. However, TTX, 1 x 10 -5 M, did not abolish action potentials recorded from cells in 6-day-old atria. TTX-sensitive receptor sites were present in 6-day-old atrial membranes because the toxin depressed the early Na + conductance that generated the rapid depolarization phase and the maximum rate of rise of the action potential. TTX at 0.9 x 10 -8 M reduced the maximum rate of rise by 50% in 6-day-old atria, and TTX at 2 x 10 -8 M had the same effect in 12- and 18-day-old preparations. Action potential overshoot changed about 10-20 mv/tenfold variation in external Na + concentration in 6-day-old atria in contrast to the change of about 60 mv/decade observed in 18-day-old atria. Moreover, the TTX-resistant action potentials in 6-day-old atria depended primarily on an inward Ca 2+ current because overshoot changed 24 mv/decade variation in external Ca 2+ concentration. The improvement in sodium-electrode properties that occurred during maturation was accompanied by an increase in the maximum rate of rise of the action potential, which averaged 64 v/sec in 6-day-old atria and 94 v/sec in 18-day-old atria. These findings suggested that the early Na + conductance mechanism became more critical in generating the action potential in older embryonic atria. These data were consistent with the hypothesis that the membrane density of early conductance sites increased with embryonic age. The TTX resistance of 6-day-old atria depended on an inward Ca 2+ current that generated action potentials after the early Na + conductance sites had been blocked by the toxin.
George Alexander Mogey
Authors: John L Duncan
Journal: BMJ (2004)

Epidemiologist who discovered the Lassa fever virus-and nearly died from it Jordi Casals-Ariet, an epidemiologist and virologist, was hailed by scientists around the world when he discovered the virus that causes Lassa fever.He was nearly killed by the disease in 1969 while working with the virus in his Yale laboratory.In a high-stakes gamble and with no known treatment, his doctors decided to transfuse him with blood from a nurse who had survived Lassa fever.The blood saved his life.But colleagues say that Dr Casals' contributions are far greater than his discovery of the Lassa fever virus."He did a yeoman's work in establishing useful methods of classifying viruses," said Dr Gregory Tignor, professor emeritus at Yale, who worked with Dr Casals.Little was known about many viruses when Dr Casals started his work at Yale. "Everybody has forgotten how bad it was back then," said Dr Tignor."People didn't know what was causing encephalitis.We had no way of telling the difference between rabies encephalitis, polio encephalitis, or other causes of encephalitis.But Jordi found ways, using antigens and antibodies, to figure it out.His work was so meticulous that to this day nobody has changed his classifications because they have all held up."
Editorial
Authors: ALBERT DORFMAN
Journal: Circulation (1964)

Treatment of Acute Rheumatic Pancarditis DESPITE the widespread adoption of ad- renocortical hormone therapy for many inflammatory diseases, there remains a significant difference of opinion concerning the treat- ment of acute rheumatic fever.This difference of opinion derives largely from the difficulty of conducting large-scale prospective studies.Even when such studies are carried out, their validity is limited to the conditions of the par- ticular study including such variables as case selection, drug choice, dosage schedule, and criteria for follow-up.The three large-scale controlled studies that have appeared in the literature have all been conducted under dif- ferent conditions.' 3 Differences in results may stem from these variations.The U.K. and U.S. Cooperative Study employed dosages and pe- riods of time considerably less than used in most centers at present.The results obtained cannot be strictly compared to those of Dorf- man et al.,2 who used larger doses for longer periods of time.The decrease in incidence of residual heart disease as measured by murmurs present at 1 year, observed by these investiga- tors, was not observed in another controlled study 3 when somewhat comparable doses of drugs were used on what was apparently a group of patients with somewhat more serious heart disease.This discrepancy has not been completely resolved, so that there is as yet no uniform agreement regarding treatment of all
Polyvalent Influenza Vaccine-Reply
Authors: P. F. R. de Caires
Journal: JAMA (1963)

<h3>To the Editor:—</h3> Parke, Davis &amp; Company has had reports of granulomatous formations following the intradermal administration of aluminum-phosphate-adsorbed vaccines (such as Resprogen) similar to those observed by Dr. Shwayder. Intradermal administration is not recommended. The route of administration advised is intramuscular and the dose is 1 cc initially and another 1 cc intramuscularly 2 weeks to 1 month later. Microscopic examination of such a lesion revealed that the changes were those of a chronic granulomatous process caused by an irritant substance.
Medicare risk contracting. Lessons from an unsuccessful demonstration
Authors: G. R. Nycz
Journal: JAMA (1987)

The Tax Equity and Fiscal Responsibility Act of 1982 provided a full-risk Medicare capitation financing option for health maintenance organizations and competitive medical plans. Two rounds of demonstrations were conducted, followed by the publication of final regulations in January 1985. The first-round demonstration at Marshfield, Wis, was operational for 28 months. Thirty-seven percent of all resident beneficiaries enrolled. Aggregate losses exceeded $3 million (11.6% of revenue). Management implemented increasingly more stringent utilization review. Overall hospital utilization declined 261.7 days per 1000 from fiscal year 1981 to 1982; nonetheless, federal reimbursement was insufficient to meet program costs and the demonstration was terminated. The central reimbursement method used in Medicare risk contracting (adjusted average per capita cost) does not adequately control for enrollment selection, unmet medical need, or recent regional cost variations. Reimbursement set at 95% of estimated fee-for-service costs does not recognize, and in the long run will not support, an efficiently operating delivery system. (<i>JAMA</i>1987;257:656-659)
Multiple Lung Perfusion Defects in a Patient with Takayasu??s Arteritis
Authors: J W REINIG, J T SIMMONS, L BIELROY, C LEWALLEN
Journal: Clinical Nuclear Medicine (1985)

Takayasu's arteritis has been noted to affect pulmonary arteries as well as systemic vessels. Ventilation/perfusion mismatches can be demonstrated in these patients on lung scans. We present a case in which multiple perfusion defects were the result of vasculitis rather than pulmonary emboli.
Abstract 3931: Whole genome and whole exome sequencing of head and neck cancer
Authors: Nicolas Stransky, Ann Marie Egloff, Aaron Tward, Daniel Auclair, Kristian Cibulskis, Michael Lawrence, Andrey Sivachenko, Michael Berger, Raja Seethala, Carrie Sougnez, Maria Cortes, Wendy Winckler, Stacey Gabriel, Gad Getz, Todd Golub, Jennifer Grandis, Levi Garraway
Journal: Cancer Research (2011)

Abstract Head and neck cancer is responsible for an enormous cancer burden worldwide, with an estimated 500,000 new cases per year. However, knowledge of the spectrum of genetic alterations that drive this malignancy remains incomplete. Previous studies of this disease have identified recurrent somatic mutations in a few specific genes, but few systematic genome-scale studies have been performed. Accordingly, we have undertaken a pilot study of complete genome/exome characterization in this malignancy. We obtained genomic DNA from 40 head and neck tumors together with matched normal DNA from whole blood. To date, we have obtained whole exome sequencing of 28 tumor/normal pairs and whole genome sequencing of two tumor/normal pairs. The average base mutation rate is 3.1 × 10-6 (range = 2.9 × 10-7 to 8.8 × 10-6), consistent with rates observed in lung cancer and other tobacco-related malignancies. We also identified 24 high-confidence somatic rearrangements in one sample and 120 in the other sample (including 7 and 44 inter-chromosomal rearrangements, respectively). In addition to frequent mutations of TP53 (53%), HRAS, PIK3CA, and PTEN, we also observed other recurrently mutated genes that implicate several oncogenic pathways. Furthermore, layering of somatic mutation data onto known pathway information strengthens the evidence for several oncogenic processes not previously implicated in head and neck cancer. Altogether, these data should enhance our understanding of the mechanisms that drive head and neck carcinogenesis and progression and may also illuminate new therapeutic opportunities. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3931. doi:10.1158/1538-7445.AM2011-3931
Controlled Trial of Chlormethiazole in Treatment of the Alcoholic Withdrawal Phase
Authors: M. M. Glatt, H. R. George, E. P. Frisch
Journal: BMJ (1965)

BRITUNA 401 vertically from too great a distance (Fig. 2, iii) penetration of the skin was inadequate.The correct depth of injection was achieved (Fig. 2, iv) by pushing up a small " hump " of skin in front of the nozzle when the gun was fired at an angle of 30 to 45 degrees to the skin.A weal approximately 5-8 mm. in diameter could always be seen when the vaccine had been correctly given.A smaller or an absent weal was not taken as an indication for a second " shot."Correct Dosage.-Theamount of fluid fired from each gun at each shot remained constant; but it was always less than 0.1 ml. in volume, and was found to average 0.06 to 0.08 ml. with the instrument used.A dose of vaccine equivalent to that in 0.1 ml.given intradermally could be administered by suit- ably adjusting the amount of sterile water or saline-for example, by using 3 ml. of suspension for a 5-ml.ampoule- in which the dried vaccine was resuspended, and when this procedure was adopted highly satisfactory results were obtained (Fig. 3). SummaryA method of rapid, painless, automatic, and effective intra- dermal B.C.G. vaccination with the Dermo-jet injector is described.A total of 758 schoolchildren were vaccinated by this method at the same time as 784 children who were vaccinated by the intradermal technique with the same batches of vaccine as controls.The results of intradermal jet vaccination were satisfactory as compared with those of the usual method of intradermal vaccination.We wish to thank the Medical Officers of Health concerned-Dr.Arnold Brown (Cheshire), Dr. Metcalfe Brown (Manchester), and Dr. G. Ramage (Staffordshire)-for allowing this investigation to be carried out and for their encouragement and interest.The B.C.G. vaccine
HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose
Authors: R. Clark Perry, R. Ravi Shankar, Naomi Fineberg, Janet McGill, Alain D. Baron
Journal: Diabetes Care (2001)

OBJECTIVE—Whereas new diagnostic criteria based on a fasting plasma glucose (FPG) of &amp;gt;126 mg/dl (7.8 mmol/l) have improved the detection of diabetes, multiple reports indicate that many people with diabetes diagnosed by 2-h oral glucose tolerance test (OGTT) glucose measurements of ≥11.1 mmol/l (200 mg/dl) would remain undiagnosed based on this FPG criteria. Thus, improved methods to detect diabetes are particularly needed for high-risk individuals. We evaluated whether the combination of FPG and HbA1c measurements enhanced detection of diabetes in those individuals at risk for diabetes with nondiagnostic or minimally elevated FPG. RESEARCH DESIGN AND METHODS—We analyzed FPG, OGTT, and HbA1c data from 244 subjects screened for participation in the Early Diabetes Intervention Program (EDIP). RESULTS—Of 244 high-risk subjects studied by FPG measurements and OGTT, 24% of the individuals with FPG levels of 5.5–6.0 mmol/l (100–109 mg/dl) had OGTT-diagnosed diabetes, and nearly 50% of the individuals with FPG levels of 6.1–6.9 mmol/l (110–125 mg/dl) had OGTT-diagnosed diabetes. In the subjects with OGTT-diagnosed diabetes and FPG levels between 5.5 and 8.0 mmol/l, detection of an elevated HbA1c (&amp;gt;6.1% or mean + 2 SDs) led to a substantial improvement in diagnostic sensitivity over the FPG threshold of 7.0 mmol/l (61 vs. 45%, respectively, P = 0.002). Concordant FPG levels ≥7.0 mmol/l (currently recommended for diagnosis) occurred in only 19% of our cohort with type 2 diabetes. CONCLUSIONS—Diagnostic criteria based on FPG criteria are relatively insensitive in the detection of early type 2 diabetes in at-risk subjects. HbA1c measurement improves the sensitivity of screening in high-risk individuals.
THE IMPACT OF HINGE MOTION ON IN-STENT RESTENOSIS AFTER SIROLIMUS-ELUTING STENT IMPLANTATION
Authors: Yasushi Ino, Hironori Kitabata, Atsushi Tanaka, Takashi Kubo, Shigeho Takarada, Takashi Tanimoto, Kennichi Komukai, Kouhei Ishibashi, Keishi Ookouchi, Akio Kuroi, Aiko Shimokado, Kumiko Hirata, Masato MIzukoshi, Toshio Imanishi, Takashi Akasaka
Journal: Journal of the American College of Cardiology (2010)
723-4 Cardiovascular and Neurohormonal Effects of SDZ WAG 994, a Selective Adenosine A 1 Receptor Agonist, in Man
Authors: Inder Anand, Y. Chandrashekhar, Anne McCauley, Susan Ziesche, Michelle Berg, Dianne Judd, Nardev Khurmi, Jay N. Cohn
Journal: Journal of the American College of Cardiology (1995)
Anisakiasis caused by herring in vinegar: a little known medical problem.
Authors: M A Verhamme, C H Ramboer
Journal: Gut (1988)

Six cases of intestinal anisakiasis, or herring worm disease, diagnosed over a two year period in a Belgian gastroenterology unit are described. They presented mainly as intestinal obstructions and larvae of this marine nematode were found in the intestinal wall of two of the four patients who were operated on. In two other patients awareness of the diagnosis permitted conservative treatment and spontaneous healing. In five patients symptoms developed after they had eaten herring marinated in vinegar, a hitherto little known source of the herring worm disease.