tbuckley/cabot-search huggingface dataset:
Better care for elderly will replace some "box ticking" under new GP contract
Authors: G. Iacobucci
Journal: BMJ (2013)

GPs in England face sweeping changes to their contract from next year, with substantial reductions in “box ticking” in exchange for new responsibilities. These include ensuring that all patients aged 75 years or older have a “named GP” and monitoring the care that patients receive outside surgery hours.

The agreement between the BMA’s General Practitioners Committee and NHS Employers will shift £450m (€540m; $725m) worth of funding from the Quality and Outcomes Framework (QOF) into other areas, with around £290m invested in GPs’ core funding, and the remainder used to fund a new scheme for preventing patients being inappropriately admitted to hospital.

The health secretary, Jeremy Hunt, said that the deal would reduce pressure on hospitals’ accident and emergency departments and reverse the “mistakes” of Labour’s 2004 GP contract, which he said “broke the personal link between GP and patient.”

The BMA also welcomed the …
Irritable bowel syndrome: diagnosis and management
Authors: A Agrawal, P J Whorwell
Journal: BMJ (2006)

<i>Irritable bowel syndrome is often dismissed as just being a nuisance rather than anything more serious, but its symptoms can seriously diminish a patient9s quality of life. When the disease is better understood and treatment is tailored to the individual patient, it can often be rewarding to manage</i>
Diagnostic devices in the undergraduate curriculum
Authors: H. Posnett, J Derodra
Journal: Journal of the Royal Society of Medicine (2004)

Andreas Demetriades (May 2004 JRSM1) comments on the difficulty educators face in deciding which clinical techniques deserve preservation in an age of imaging technologies. Even Laennec faced opposition from those who saw the stethoscope as a threat to traditional practice. Today a case in point is the diagnosis of varicose veins. Management decisions depend on assessment of valvular incompetence, for which medical students are taught the tap test, the cough test and the Trendelenburg tourniquet test. Yet in practice vascular surgeons use hand-held doppler probes and perform duplex scans as necessary. We reviewed the published work regarding accuracy of these clinical tests.

In 1984 McIrvine et al.2 compared clinical tests for saphenofemoral incompetence with findings at surgery in 105 patients. The simplest and most accurate method was the tourniquet test plus hand-held doppler (sensitivity 0.90, specificity 0.45). More recently, De Palma et al.3 found the sensitivities of clinical tests and hand-held doppler to be about the same (0.48) but the addition of doppler to clinical tests raised the sensitivity and increased positive predictive value to 83%. Singh et al.4 asked surgeons ‘hypothetically’ to commit to one of a selection of management protocols having seen findings at preoperative assessment. Inappropriate surgery would have been performed in 20% of limbs on the basis of clinical examination with a tourniquet and in 13% on the basis of tourniquet examination plus hand-held doppler. Kim et al.,5 using duplex scanning as their gold standard, found that the sensitivities of clinical tests ranged from 0.18 to 0.97 and specificities from 0.20 to 0.92. Hand-held doppler was far superior, with sensitivity 0.97 and specificity 0.73 at the saphenofemoral junction.

On the above evidence, clinical tests alone are of low value in assessment of varicose veins and medical education should embrace hand-held doppler.
Glomerular filtration rate measurement by “single-shot” injection of inulin
Authors: Klaas W. Florijn, Jos N.M. Barendregt, Eef G.W.M. Lentjes, Wim van Dam, Wiguno Prodjosudjadi, Jan L.C.M. van Saase, Leendert A. van Es, Peter C. Chang
Journal: Kidney International (1994)
An annual cycle in the ventilatory capacity of men with pneumoconiosis and of normal subjects
Authors: C. B. McKerrow, C. E. Rossiter
Journal: Thorax (1968)

The forced expiratory volume over 0·75 second (F.E.V.<sub>0·75</sub>) was measured monthly for 3 years in 28 working ex-miners with pneumoconiosis and for one year in 17 normal laboratory workers. A significant annual cyclical variation of 0·044 litre amplitude was found in the ex-miners, with minimum and maximum values on 2 February and 3 August respectively. In the normal subjects the amplitude of the change was about 0·10 litre. An attempt was made to relate the changes in ventilatory capacity in the ex-miners to those in environmental temperature, relative and absolute humidity, and barometric pressure. Dry-bulb temperature showed a cyclical pattern in phase with that of ventilatory capacity, but there was no strong correlation between the deviations from these cyclical components, which would have been desirable to support a causal relation between change of temperature and of ventilatory capacity. There was no definite evidence of a relationship between any other of the environmental parameters and ventilatory capacity. Fourteen of the ex-miners had purulent sputum at intervals but remained at work. Immediately after these attacks the ventilatory capacity was not lower than before, but those having attacks showed a greater annual decline in their F.E.V.<sub>0·75</sub>. We think that the cyclical variation in ventilatory capacity is not directly caused by the environmental conditions measured, or by sputum purulence, but could represent an intrinsic biological rhythm which is perhaps modified by the environmental temperature.
Influence of Modified Posterior Reconstruction of the Rhabdosphincter on Early Recovery of Continence and Anastomotic Leakage Rates after Robot-Assisted Radical Prostatectomy
Authors: Rafael F. Coelho, Sanket Chauhan, Marcelo A. Orvieto, Ananthakrishnan Sivaraman, Kenneth J. Palmer, Geoff Coughlin, Vipul R. Patel
Journal: European Urology (2010)
POST-OPERATIVE INFECTION OF THE EYE.
Authors: JOSEPH A. WHITE
Journal: JAMA (1904)

The subject of infection of the eye following operations that expose the interior of the globe to the possibility of bacterial invasion, such as cataract extractions, needle operations and iridectomies, is one of doubtful interest in these days of modern antiseptic methods, because such an unfortunate result of an operation is regarded askance, as if it could only have happened through neglect of well-established precautions by the operator. I suppose this accounts for the fact that it is hardly mentioned by our latter-day text-books, it being taken for granted that if these precautions are taken, it is hardly worth the space or time to discuss a bare possibility, as the space is needed for what is more commonly met with. Moreover, when it does occur it is practically regarded as a hopeless affection, not remediable by any known methods of treatment, and this pessimistic aspect of the subject
Pharmaceutical Companies: The Perfect Scapegoat for Everything
Authors: Pepe Lee Chang
Journal: The American Journal of Bioethics (2013)

Click to increase image sizeClick to decrease image size Notes Although we can imagine a situation where the belief is entirely unjustified and yet turns out to be true. I will not be addressing the legal assignment of responsibility here. It is enough for my argument to present the normative principles that would ground such laws.
Physicians and the Olympics
Authors: Jeffrey P. Koplan
Journal: JAMA (1984)

The Summer Olympic Games were last held in the United States in 1932, in Los Angeles. During the past 52 years, athletic performances have improved, and the composition of the Games has changed. The public, including physicians, have become increasingly interested in sports. And the ability of health professionals to prevent and treat sports-related injuries has greatly improved, and exercise as a health-promoting activity has become more widely accepted. Evidence of the growing interest and concern of the medical community in the medical aspects of sport and exercise is provided by our participation in professional organizations and our literature. In 1954, the American College of Sports Medicine had 11 members; in 1983, there were 10,421 members, about a third of whom were physicians. Since 1930, the number of scientific journal articles pertaining to sports, fitness, and exercise has increased three times faster than the total number of medical articles and
Phobic Anxiety and Risk of Coronary Heart Disease and Sudden Cardiac Death Among Women
Authors: Christine M. Albert, Claudia U. Chae, Kathryn M. Rexrode, JoAnn E. Manson, Ichiro Kawachi
Journal: Circulation (2005)

Background— High levels of phobic anxiety have been associated with elevated risks of coronary heart disease (CHD) death and sudden cardiac death (SCD) among men. To the best of our knowledge, no studies have looked at this association among women. Anxiety may influence CHD mortality by increasing the risk of ventricular arrhythmia and SCD. Methods and Results— We prospectively examined the relationship between phobic anxiety, as measured by the Crown-Crisp index (CCI), and CHD among women participating in the Nurses’ Health Study. Among 72 359 women with no history of cardiovascular disease or cancer in 1988, 97 SCDs, 267 CHD deaths, and 930 nonfatal myocardial infarctions (MI) were documented over 12 years of follow-up. A higher score on the CCI was associated with an increased risk of SCD and fatal CHD but not of nonfatal MI in age-adjusted ( P , trend ≤0.008) and in multivariable models excluding possible biological intermediaries ( P , trend ≤0.03). Multivariable adjustment appeared to attenuate the relations; women who scored 4 or greater on the CCI were at a 1.59-fold (95% CI, 0.97 to 2.60) marginally increased risk of SCD and a 1.31-fold (95% CI, 0.97 to 1.75) marginally increased risk of fatal CHD compared with those who scored 0 or 1. After control for possible intermediaries (hypertension, diabetes, and elevated cholesterol), a trend toward an increased risk persisted for SCD ( P =0.06). Conclusions— These prospective data suggest that high levels of phobic anxiety are associated with an increased risk of fatal CHD, particularly from SCD. Some but not all of this risk can be accounted for by CHD risk factors associated with phobic anxiety.
In the Wake of Hurricane Andrew
Authors: W. Gary Hlady
Journal: JAMA (1995)

To the Editor.  —We are concerned that the article by Ms Friedman1inaccurately presents the facts regarding Hurricane Andrew and is misguided in some of its recommendations for responding to sudden-impact natural disasters.  First, 14 deaths occurred because of the hurricane, not 58 as reported.2Active surveillance of morbidity after the hurricane indicated no increase in enteric or respiratory illness. In the acute recovery phase of the hurricane and also during subsequent months, surveillance detected no cases of typhus, no waterborne outbreaks of dysentery or other waterborne diseases, and no increase in animal rabies. A single case ofHantavirusinfection, a human rabies case acquired overseas, and an outbreak of typhoid all occurred more than 1 year later, with epidemiologic and environmental investigation yielding no evidence that they were related to the hurricane. Immunization was not a part of the disaster response, and the assertion that it should
Interferon alfa and gamma inhibit proliferation and collagen synthesis of human ito cells in culture
Authors: Ariane Mallat, Anne-Marie Preaux, Sylvie Blazejewski, Jean Rosenbaum, Daniel Dhumeaux, Philippe Mavier
Journal: Hepatology (1995)

During the course of ongoing liver fibrogenesis, Ito cells acquire myofibroblastic features, proliferate, and synthesize increased amounts of extracellular matrix components. Interferon (IFN) alfa and IFN gamma have been shown to elicit antiproliferative and/or antifibrogenic effects in various cell cultures of mesenchymal origin. The aim of this study was to investigate the effects of IFN-alpha and IFN-gamma on cultured human myofibroblastic Ito cells (MFBIC) proliferation and collagen synthesis and secretion. Serum-stimulated incorporation of [3H]-thymidine into DNA of MFBIC was dose-dependently decreased by both cytokines. IFN-alpha (10(4) U/mL) and IFN-gamma (10(3) U/mL) decreased DNA synthesis by 69% and 66%, respectively. Inhibition of cell proliferation was confirmed by cell counting. Similar results were observed when cell growth was stimulated with platelet-derived growth factor (PDGF-BB, PDGF-AA) or transforming growth factor (TGF)-beta 1. Collagen secretion per cell was inhibited by both cytokines, as assessed by [3H]-hydroxyproline incorporation. After a 6-day treatment, IFN-gamma showed a greater potency than IFN-alpha in inhibiting secretion of newly synthetized collagen (41% and 4% of control in the presence of 10(2) U/mL of IFN-gamma and 10(4) U/mL of IFN-alpha, respectively). Both IFN-alpha and IFN-gamma concurrently decreased steady-state expression of type I and type III procollagen messenger RNAs (mRNAs) in quiescent MFBIC. Viability assays ruled out cytotoxic effects of the two molecules. Finally, both IFNs decreased smooth muscle alpha-actin (SM alpha-actin) expression, whether assayed by immunoblotting or by Northern blot analysis. We conclude that IFN-alpha and IFN-gamma inhibit proliferation as well as collagen synthesis in human MFBIC.
NEW ETHER PAD AND CONE
Authors: EDWIN M. Jones
Journal: JAMA (1913)

The illustrated pad and cone were devised to make the administration of ether more agreeable to the patient and infinitely easier for the administrator as compared with the methods now used in over 85 per cent. of the hospitals.  Unless the anesthetic is in the hands of a professional it is usually given by using an Esmarch cone, towels, petrolatum, rubber tissue and moist cotton for the eyes, all of which are useless and hard to handle, and before the patient is asleep they are usually out of place and the eyes exposed to the ether vapors. The cone in this case does not fit, consequently the vapors escape down the sides of the patient's face, hence the waste of ether; and the administrator has no idea of the ether percentage he is giving, but hopes the patient will soon be asleep so he can arrange the towels, which he
Ototoxicity of Ethacrynic Acid and Aminoglycoside Antibiotics in Uremia
Authors: Robert H. Mathog, William J. Klein
Journal: New England Journal of Medicine (1969)

THE ototoxic effects of aminoglycosides such as streptomycin, kanamycin and neomycin are well established. Since renal failure increases the hazard of ototoxicity from these drugs, it can be expected that, in the presence of azotemia and delayed drug excretion, other agents thought to be minimally ototoxic may exhibit an enhanced capacity for this adverse effect.1 Before the report of Schneider and Becker2 ethacrynic acid was not considered an ototoxic drug. They described the induction of acute transient hearing loss by ethacrynic acid in five patients with marked impairment of renal function.Others3 4 5 6 have alluded to single cases of similar effects. . . .
Clinical Trial Investigators and Their Prescribing Patterns
Authors: Bruce M. Psaty, Drummond Rennie
Journal: JAMA (2006)

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Preliminary Evidence for Herpes labialis Recurrence following Experimentally Induced Disgust
Authors: Angelika Buske-Kirschbaum, Andrea Geiben, Cornelia Wermke, Karl-Martin Pirke, Dirk Hellhammer
Journal: Psychotherapy and Psychosomatics (2001)

&lt;i&gt;Background:&lt;/i&gt; After primary orofacial infection with the herpes simplex virus (type 1, HSV-1), up to 40% of HSV seropositive subjects suffer recurrent herpes infections which are characterized by painful erosions of the involved skin mainly around the lips (herpes labialis). Besides various other factors, there is growing evidence suggesting that psychosocial factors might trigger HSV. The present study was designed to investigate modulation of recurrent HSV infection by experimentally induced emotional distress. &lt;i&gt;Methods:&lt;/i&gt; Among patients with herpes labialis (n = 91), subjects who showed recurrent HSV infection (&gt;5 acute infections/year) and who reported to suffer from HSV symptoms exclusively after confrontation with dirty dishes, i.e. dirty plates or dirty glasses were selected by standardized interview. Subjects (n = 20) were randomly assigned to two treatment groups. The experimental group (n = 10) was first exposed to 5 slides showing dirty glasses and subsequently to the glasses previously presented on the slides in vivo. The control group (n = 10) was exposed to neutral slides and neutral objects. In order to determine the proportion of leukocyte subpopulations and concentrations of tumor necrosis factor α (TNF-α), blood samples were collected 15 min before as well as 40 min and 48 h after stimulus presentation. Saliva cortisol was obtained 45, 20, 15 and 1 min before and 1, 10, 20 and 30 min after stimulus confrontation. &lt;i&gt;Results:&lt;/i&gt; Medical examination of the volunteers 48 h after the experiment indicated that four experimental subjects showed HSV-1 symptoms while not a single herpetic infection could be determined in the control subjects (p = 0.033). Moreover, significantly elevated concentrations of TNF-α were observed in the experimental, but not in the control group. No significant alterations of the number of leukocyte subpopulations were found 30 min or 48 h after stimulus presentation. Further, cortisol concentrations were found to be unchanged after the treatment. &lt;i&gt;Conclusions:&lt;/i&gt; The present findings suggest that experimentally induced emotional stress such as disgust may be associated with reactivation of HSV.
Genome wide SNP array identified multiple mechanisms of genetic changes in Waldenstrom macroglobulinemia
Authors: Stéphanie Poulain, Christophe Roumier, Sylvie Galiègue‐Zouitina, Agnès Daudignon, Charles Herbaux, Rachid Aiijou, Amélie Lainelle, Natacha Broucqsault, Elisabeth Bertrand, Salomon Manier, Aline Renneville, Valérie Soenen, Sabine Tricot, Catherine Roche‐Lestienne, Patrick Duthilleul, Claude Preudhomme, Bruno Quesnel, Pierre Morel, Xavier Leleu
Journal: American Journal of Hematology (2013)

SNP array (SNPa) was developed to detect copy number alteration (CNA) and loss of heterozygosity (LOH) without copy number changes, CN‐LOH. We aimed to identify novel genomic aberrations using SNPa in 31 WM with paired samples. Methylation status and mutation were analyzed on target genes. A total of 61 genetic aberrations were observed, 58 CNA (33 gains, 25 losses) in 58% of patients and CN‐LOH in 6% of patients. The CNA were widely distributed throughout the genome, including 12 recurrent regions and identified new cryptic clonal chromosomal lesions that were mapped. Gene set expression analysis demonstrated a relationship between either deletion 6q or gain of chromosome 4 and alteration of gene expression profiling. We then studied methylation status and sought for mutations in altered regions on target genes. We observed methylation of DLEU7 on chromosome 13 in all patients ( n = 12) with WM, and mutations of CD79B/CD79A genes (17q region), a key component of the BCR pathway, in 15% of cases. Most importantly, higher frequency of ≥3 CNA was observed in symptomatic WM. In conclusion, this study expands the view of the genomic complexity of WM, especially in symptomatic WM, including a potentially new mechanism of gene dysfunction, acquired uniparental disomy/CN‐LOH. Finally, we have identified new potential target genes in WM, such as DLEU7 and CD79A/B . Am. J. Heamtol. 88:948–954, 2013. © 2013 Wiley Periodicals, Inc.
Expression of apolipoprotein C-IV is regulated by Ku antigen/peroxisome proliferator-activated receptor γ complex and correlates with liver steatosis
Authors: Eun Kim, Ke Li, Charmiane Lieu, Shuping Tong, Shigenobu Kawai, Takayoshi Fukutomi, Yonghong Zhou, Jack Wands, Jisu Li
Journal: Journal of Hepatology (2008)
FoxO3 Controls Autophagy in Skeletal Muscle In Vivo
Authors: Cristina Mammucari, Giulia Milan, Vanina Romanello, Eva Masiero, Ruediger Rudolf, Paola Del Piccolo, Steven J. Burden, Raffaella Di Lisi, Claudia Sandri, Jinghui Zhao, Alfred L. Goldberg, Stefano Schiaffino, Marco Sandri
Journal: Cell Metabolism (2007)
Methylseleninic Acid Enhances Taxane Drug Efficacy against Human Prostate Cancer and Down-Regulates Antiapoptotic Proteins Bcl-XL and Survivin
Authors: Hongbo Hu, Guang-xun Li, Lei Wang, Jennifer Watts, Gerald F. Combs, Junxuan Lü
Journal: Clinical Cancer Research (2008)

Abstract Purpose: Our previous work has shown that methylseleninic acid (MSeA) sensitized hormone refractory prostate cancer (HRPCa) cells to apoptosis induced by paclitaxel (Taxol) through enhancing multiple caspases. This study aimed to (a) determine the general applicability of the sensitization effect for taxane drugs in vitro, (b) establish the enhancement of paclitaxel efficacy by MSeA in vivo, and (c) investigate Bcl-XL and survivin as molecular targets of MSeA to augment apoptosis. Experimental design: DU145 and PC-3 HRPCa cell lines were used to evaluate the in vitro apoptosis effects of paclitaxel, docetaxel and their combination with MSeA, and the molecular mechanisms. DU145 xenograft growth in athymic nude mice was used to evaluate the in vivo efficacy of paclitaxel and its combination with MSeA. The tumor samples were used to examine Bcl-XL and survivin protein abundance. Results: MSeA combination with paclitaxel or docetaxel exerted a greater than additive apoptosis effect on DU145 and PC-3 cells. In nude mice, paclitaxel and MSeA combination inhibited growth of DU145 subcutaneous xenograft with the equivalent efficacy of a four-time higher dose of paclitaxel alone. MSeA decreased the basal and paclitaxel-induced expression of Bcl-XL and survivin in vitro and in vivo. Ectopic expression of Bcl-XL or survivin attenuated MSeA/paclitaxel-induced apoptosis. Conclusions: MSeA enhanced the efficacy of paclitaxel against HRPCa in vitro and in vivo, at least in part, by down-regulating the basal and paclitaxel-induced expression of both Bcl-XL and survivin to increase caspase-mediated apoptosis. MSeA may be a novel agent to improve taxane combination therapy.