tbuckley/cabot-search huggingface dataset:
How electronic communication is changing health care: Usability is main barrier to effective electronic information systems
Authors: Douglas Badenoch, Andre Tomlin
Journal: BMJ (2004)

How electronic communication is changing health care Usability is main barrier to effective electronic information systemsEditor-Jadad and Delamothe celebrate "the return of the human" to health informatics in their editorial asking what's next for electronic communication and health care. 1 The question is not whether we need to merge human centred and technology centred approaches: the question is how to do it.If electronic resources are to improve health they have to be accessible, reliable, and usable.More than 80% of websites are currently not accessible by all, including most primary care trust and healthcare charity sites. 2 And according to our unpublished in-house survey, few electronic resources are subject to the rigour we would expect of reliable, evidence based publications, and many of the high quality resources that exist are prohibitively difficult to use in everyday practice.Usability concerns whether an information system is structured so that users can get an answer to fit their purpose.The solution to this problem is user centred design. 3So why isn't it happening in health care?In spite of considerable evidence that user centred design results in cost savings downstream, and a clear need to assess the usability of information systems, 4 the perception remains that it is too expensive.A good first step is the creation of effective, free tools that help us assess the usability of electronic resources quickly, such as our LIDA tool (www.minervation.com/downloads.html).These are needed to show where the problems are in resources that already exist.Once the usability problem has been identified and defined and both users and commissioners have been educated to expect better from information technology systems, momentum will be gathered towards genuinely high quality electronic information systems.
THE INCIDENCE OE BUCCAL PIGMENTATION IN CAUCASOIDS AND NEGKOIDS IN BKITAIN
Authors: LIONEL FRY, JOHN R. ALMEYDA
Journal: British Journal of Dermatology (1968)

SUMMARY. One hundred consecutive coloured and 100 consecutive white European (light skinned causasoids—LSC) patients were examined to determine the incidence of buccal pigmentation. In the coloured patients it was 38% and in the LSC patients 5%. In these 5 LSC patients general examination and investigation revealed none of the disorders usually associated with buccal pigmentation, which cannot therefore be regarded as necessarily a sign of systemic disease, notably Addison's disease. In coloured patients the presence of buccal pigmentation is rarely of diagnostic significance.
Adherence to acitretin and home narrowband ultraviolet B phototherapy in patients with psoriasis
Authors: Brad A. Yentzer, Christopher B. Yelverton, Daniel J. Pearce, Fabian T. Camacho, Zaineb Makhzoumi, Adele Clark, Ann Boles, Alan B. Fleischer, Rajesh Balkrishnan, Steven R. Feldman
Journal: Journal of the American Academy of Dermatology (2008)
World could eliminate health inequalities between nations by 2035
Authors: I. Torjesen
Journal: BMJ (2013)

The world has the financial and technical capacity to eliminate health disparities between poor and wealthy nations within a generation, says a major new report published in the Lancet .1

For the first time, governments and donor organisations have the power to reduce preventable deaths from infections and maternal and child mortality in all countries to the levels seen in the best performing middle income countries, it says.

Prompted by the 20th anniversary of the World Bank’s 1993 world development report, which focused on investment in health, a Lancet commission of 25 leading experts on global health and economists revisited the case for boosting investment in health. The commission developed a new investment framework for low and middle income countries, showing where spending should be prioritised to achieve dramatic health gains by 2035. It …
Proximal Cerebral Arteries Develop Myogenic Responsiveness in Heart Failure via Tumor Necrosis Factor-α–Dependent Activation of Sphingosine-1-Phosphate Signaling
Authors: Jingli Yang, M. Hossein Noyan-Ashraf, Anja Meissner, Julia Voigtlaender-Bolz, Jeffrey T. Kroetsch, Warren Foltz, David Jaffray, Amita Kapoor, Abdul Momen, Scott P. Heximer, Hangjun Zhang, Matthijs van Eede, R. Mark Henkelman, Stephen G. Matthews, Darcy Lidington, Mansoor Husain, Steffen-Sebastian Bolz
Journal: Circulation (2012)

Background— Heart failure is associated with neurological deficits, including cognitive dysfunction. However, the molecular mechanisms underlying reduced cerebral blood flow in the early stages of heart failure, particularly when blood pressure is minimally affected, are not known. Methods and Results— Using a myocardial infarction model in mice, we demonstrate a tumor necrosis factor-α (TNFα)–dependent enhancement of posterior cerebral artery tone that reduces cerebral blood flow before any overt changes in brain structure and function. TNFα expression is increased in mouse posterior cerebral artery smooth muscle cells at 6 weeks after myocardial infarction. Coordinately, isolated posterior cerebral arteries display augmented myogenic tone, which can be fully reversed in vitro by the competitive TNFα antagonist etanercept. TNFα mediates its effect via a sphingosine-1-phosphate (S1P)–dependent mechanism, requiring sphingosine kinase 1 and the S1P 2 receptor. In vivo, sphingosine kinase 1 deletion prevents and etanercept (2-week treatment initiated 6 weeks after myocardial infarction) reverses the reduction of cerebral blood flow, without improving cardiac function. Conclusions— Cerebral artery vasoconstriction and decreased cerebral blood flow occur early in an animal model of heart failure; these perturbations are reversed by interrupting TNFα/S1P signaling. This signaling pathway may represent a potential therapeutic target to improve cognitive function in heart failure.
Medical Education and The Role of Psychiatry
Authors: Joseph Lerner
Journal: JAMA (1966)

<h3>To the Editor:—</h3> A great deal is said and written about the current practices in the psychiatric training of physicians. Actually, the medical schools in the various states differ widely in the effectiveness of their training and some are surprisingly exiguous in their approach to the problem. As psychiatric consultants for the Social Security Administration, we reviewed thousands of medical and psychiatric reports over a period of seven years. Our experience indicates that there is a widespread inconsistency and inadequacy in the orientation not only of psychiatrists but also of physicians who submit these reports. Titmus said, "At the present time, too many family doctors are unable, or unwilling to cope with mental illness." Even in the schools which provide an adequate orientation (I avoid the use of the terms training or education advisedly), the major portion of medical students go out to their various professional activities without any real
Making clinical informatics work
Authors: P. Lelliott
Journal: BMJ (1994)

Don't forget the doctor is the customer

The introduction of new technology into medicine has been limited by cost and ethical considerations rather than doctors' resistance. Far from being Luddites, doctors have taken a lead in developments. Why then do recent initiatives in health service information systems leave them so cold? The short answer is that doctors regard the current systems, unlike technology that they have embraced, as offering no obvious benefits either for patient care or for their own working conditions.

The information management group of the NHS Management Executive has spent eight years, and about (pounds sterlling)250m, developing and implementing an information strategy for the NHS. Despite this a recent review commissioned by the information management group from CASPE Consulting found that no computing initiative in Britain had successfully married a hospital-wide range of clinical activity with electronic means of recording.

The group's hospital information support system project (HISS)1 has led to systems that, according to the project's director, have “an administrative rather than a clinical bias.”2 These systems often do little to support patient …
Letter: Screening for phenylketonuria.
Authors: B Winokur, F E James
Journal: BMJ (1974)

thyroiditis is common (7-8 of palpable goitres in our material) and a considerable number of these cases will turn up within some years with manifest myxoedema and often advanced coronary disease if not previously treated with thyroxine in the thyroiditic phase of the disease.Fine needle biopsy may be valuable in the diagnosis of thyroid cancer but it is in- dispensable for the diagnosis of thyroiditis and thus for the prevention of myxoedema.It is a simple and innocuous method-but it is, of course, possible to manage thyroid disease also without it.-Iam, etc.,
Pharmacologic inhibition of histone demethylation as a therapy for pediatric brainstem glioma
Authors: Rintaro Hashizume, Noemi Andor, Yuichiro Ihara, Robin Lerner, Haiyun Gan, Xiaoyue Chen, Dong Fang, Xi Huang, Maxwell W Tom, Vy Ngo, David Solomon, Sabine Mueller, Pamela L Paris, Zhiguo Zhang, Claudia Petritsch, Nalin Gupta, Todd A Waldman, C David James
Journal: Nature Medicine (2014)
The effects on wound healing of three amino acids-a comparison of two models
Authors: S. G. HARVEY, J. R. GIBSON*
Journal: British Journal of Dermatology (1984)

We have utilized two different models to evaluate the role of the amino acids L‐cysteine, glycine and DL‐threonine in wound healing. Both studies used a double‐blind, placebo‐controlled, randomized treatment plan. The first model involved the use of blister bases created on human forearm skin by the ammonium hydroxide technique, whilst the second model was that of hypostatic leg ulceration. We conclude that the amino acids did not contribute to the healing of blister bases but that they were of benefit in hypostatic leg ulceration.
Genome-wide association studies with metabolomics
Authors: Jerzy Adamski
Journal: Genome Medicine (2012)

Genome-wide association studies (GWAS) analyze the genetic component of a phenotype or the etiology of a disease. Despite the success of many GWAS, little progress has been made in uncovering the underlying mechanisms for many diseases. The use of metabolomics as a readout of molecular phenotypes has enabled the discovery of previously undetected associations between diseases and signaling and metabolic pathways. In addition, combining GWAS and metabolomic information allows the simultaneous analysis of the genetic and environmental impacts on homeostasis. Most success has been seen in metabolic diseases such as diabetes, obesity and dyslipidemia. Recently, associations between loci such as FADS1, ELOVL2 or SLC16A9 and lipid concentrations have been explained by GWAS with metabolomics. Combining GWAS with metabolomics (mGWAS) provides the robust and quantitative information required for the development of specific diagnostics and targeted drugs. This review discusses the limitations of GWAS and presents examples of how metabolomics can overcome these limitations with the focus on metabolic diseases.
Points from Letters: Scotland's Anaesthetists
Authors: G. D. Parbrook
Journal: BMJ (1971)

glucose was measured sequentially, blood glucose remained below 20 mg/100 ml for longer than 24 hours.Furthermore, a hypo- glycaemic baby may develop symptoms after many hours of being asymptomatic.This occurred in an infant, seen some years ago, who had a blood glucose level of 15 mg/100 ml at 10 hours of age.He was asymptomatic and was not treated.The glucose level re- mained low until, at 75 hours of age, he had a convulsion which responded to intravenous
Anyone for Club Med?
Authors: T. Greenhalgh
Journal: BMJ (2008)

A group of Spanish epidemiologists recently published a paper in the BMJ offering evidence that we can reduce our relative risk of developing diabetes by 83% by following a strict Mediterranean diet ( BMJ 2008;336:1348-51, doi: 10.1136/bmj.39561.501007.BE). In view of my family history of the condition I made a unilateral (and, in retrospect, foolish) decision to amend the whole family’s diet.

The paper describes a Mediterranean diet as one “rich in olive oil, plant based foods (fruits, vegetables, and legumes), and fibre but low in meats.” My …
Relation of plasma lipid and apoprotein levels to progressive intimal hyperplasia after arterial endarterectomy.
Authors: N Colyvas, J H Rapp, N R Phillips, R Stoney, S Perez, J P Kane, R J Havel
Journal: Circulation (1992)

BACKGROUND To examine the relation of plasma lipoproteins to the proliferative response after arterial injury in humans, we examined the plasma lipid, lipoprotein, and apoprotein levels of 20 patients with early recurrent stenosis caused by intimal hyperplasia after carotid endarterectomy. These were compared with 20 controls who had no evidence of recurrent stenosis by duplex ultrasound scanning. METHODS AND RESULTS By univariate analysis, the reoperated patients had higher levels of plasma cholesterol (251 versus 225 mg/dl, p less than 0.05), total triglycerides (173 versus 105 mg/dl, p less than 0.03), and low density lipoprotein (LDL) apoprotein B (99.8 versus 77.2 mg/dl, p less than 0.003). The ratio of cholesterol to apoprotein B in LDL was lower in patients with restenosis (p less than 0.04), suggesting LDL of smaller diameter. High density lipoprotein (HDL) cholesterol level was reduced (45 versus 55 mg/dl, p less than 0.01) in patients with restenosis. With statistical adjustment for the correlations between these variables by multivariate analysis, both LDL apoprotein B and HDL cholesterol were independent predictors of the risk of restenosis. Ten patients with restenosis but only two controls had one or two apolipoprotein E4 alleles. CONCLUSIONS Elevated lipid levels usually associated with an increased risk of atherosclerosis may predispose patients to an increased incidence of intimal hyperplasia after endarterectomy.
Macrolides and bronchiolitis in infants
Authors: M. Korppi
Journal: European Respiratory Journal (2007)

To the Editors: 

In a recent issue of the European Respiratory Journal , Tahan et al. 1 presented their results on clarithromycin therapy in respiratory syncytial virus (RSV) bronchiolitis in 12 infants aged ≤7 months, compared with nine controls. They concluded that clarithromycin had a beneficial effect assessed by: the length of hospital stay; the need for oxygen therapy; the need for β2-agonist treatment; and the rate of readmission to hospital within the subsequent 6 months 1. The authors explained their findings in terms of …
The Clerkenwell scheme: assessing efficacy and cost of a psychiatric liaison service to a magistrates' court.
Authors: D V James, L W Hamilton
Journal: BMJ (1991)

OBJECTIVE--To determine the efficacy of psychiatric liaison schemes to magistrates9 courts in shortening the period that mentally ill accused people spend in custody between arrest, the provision of psychiatric reports, and admission to hospital under the Mental Health Act 1983 and to establish the direct costs of setting up such schemes. DESIGN--A nine month prospective study of court referrals and concurrent analysis of prison records. SETTING--An inner London magistrates9 court (Clerkenwell) and a large remand prison (Brixton). PATIENTS--Consecutive series of 80 remand prisoners receiving psychiatric assessment through a liaison scheme; 50 remand prisoners placed on hospital orders by magistrates9 courts after being remanded to prison for reports; 364 psychiatric prisoners undergoing second opinion assessments at a remand prison; 520 offenders in a remand prison placed on hospital orders. MAIN OUTCOME MEASURES--Comparison of lengths of time spent in custody for different stages of the assessment and disposal process. RESULTS--For the 50 remand prisoners assessed in prison the mean time from arrest to appearance in court with a psychiatric report was 33.7 days and from arrest to admission to hospital 50.8 days. For those examined in court under the liaison scheme the equivalent figures were 5.4 days (t = 12.63, p less than 0.0001) and 8.7 days (t = 13.04, p less than 0.0001). The number of hospital orders made at the court increased fourfold after the liaison scheme began. The additional direct costs of the scheme were negligible. CONCLUSION--Psychiatric liaison services to magistrates9 courts can greatly reduce the length of time that offenders with mental disorders spend in custody. Such schemes may increase recognition of offenders suitable for admission to hospital. A scheme could be established in some areas within existing service provision.
The Exodus of a Medical School
Authors: Edzard Ernst
Journal: Annals of Internal Medicine (1995)

Letters15 December 1995The Exodus of a Medical SchoolEdzard Ernst, MDEdzard Ernst, MDUniversity of Exeter Exeter EX2 5DW, United KingdomSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-12-199512150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I have received dozens of highly moving accounts from families directly affected by the events of 1938 in Vienna. The above three letters raise important questions on several aspects. First is the issue of Pernkopf and his atlas. In this work, the artists originally used Nazi symbols in their signatures that were removed from later editions. To characterize both Pernkopf and the Medical Faculty of the postwar period, it may be relevant to cite the official epitaph (published in the University's almanac in 1955), which makes no reference to the fact that Pernkopf supervised the “cleaning” of the ...References1. Ernst E. Funfzig Jahre danach: Medizin unter Hitler (Editorial). Perfusion. 1995;8:161. Google Scholar Author, Article, and Disclosure InformationAuthors: Edzard Ernst, MDAffiliations: University of Exeter Exeter EX2 5DW, United Kingdom PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1995Volume 123, Issue 12Page: 964KeywordsBehaviorJewish peopleNeurology ePublished: 15 August 2000 Issue Published: 15 December 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Enhancement of Electrical Stability of Acutely Ischemic Myocardium by Edrophonium
Authors: LURA A. HARRISON, LYNN H. HARRISON, KENNETH M. KENT, STEPHEN E. EPSTEIN
Journal: Circulation (1974)

Recently we demonstrated that vagal stimulation increases ventricular fibrillation threshold (VFT) and decreases the incidence of spontaneous ventricular fibrillation during acute coronary occlusion. Assuming this protective effect of the vagus to be mediated through acetylcholine release, we hypothesized that inhibition of acetylcholinesterase, a potential clinical intervention, would also enhance electrical stability of acutely ischemic myocardium. A balloon cuff was placed around the left anterior descending coronary artery (LAD) and left ventricular and atrial electrodes were implanted in 10 dogs. Five to seven days later VFT was determined (VFT was defined as the minimum current required to produce ventricular fibrillation). During nonischemic conditions VFT was 42 ± 8 ma; when edrophonium was infused (1-2 mg/kg/min), VFT increased to 77 ± 11 ma ( P &lt; 0.005). During ischemia induced by LAD occlusion VFT fell to 19 ± 4 ma. Edrophonium increased VFT during ischemia to 52 ± 13 ma ( P &lt; 0.005), a level not significantly different from preischemic values. These results suggest that enhanced electrical stability of ventricular myocardium produced by vagal stimulation is mediated by acetylcholine release, and that inhibitors of acetylcholinesterase may provide a new means of therapy for arrhythmias occurring during acute myocardial ischemia.
"ROTARY VERSION OF POMEROY"
Authors: E. W. Ayars
Journal: JAMA (1925)

<h3>To the Editor:</h3> —InThe Journal, May 9, I find in Queries and Minor Notes, page 1445, a note on "Rotary Version of Pomeroy." In October, 1922, I published in the<i>Florida State Medical Journal</i>an article entitled "Some Methods of Delivery of Occiput Posterior" in which is described the same maneuver referred to in the current issue ofThe Journal, as "Pomeroy's rotary version." About twenty-five years ago, while residing at Richburg Allegany County, N. Y., I published in the<i>Journal of the New York State Medical Association</i>(before the consolidation) a few paragraphs describing the same operation. I regret that a copy is not now available, and that I have not the date of publication. The method described is very successful.
[545] SCH 503034, AN ORAL HCV PROTEASE INHIBITOR, IS WELL-TOLERATED IN PATIENTS WITH VARYING DEGREES OF HEPATIC IMPAIRMENT
Authors: R.A. Preston, A.B. Alonso, W. Feely, S. Gupta, D. Deckman, D. Marchisin, B. Kantesaria, E. Hughes
Journal: Journal of Hepatology (2007)
PMO-232 Abnormal liver function test in patients with ulcerative colitis: a retrospective study
Authors: A A Thi, K Holbrook, R Makins
Journal: Gut (2012)

<h3>Introduction</h3> The association between primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) is well recognised. The prevalence of PSC in patients with UC has been reported widely and ranges from 2.4% to 7.5%. The mean annual incidence rates were between 0.9 and 1.3 cases per 100 000 person years. Patients with UC may frequently be found to have abnormal liver biochemistry (LFTs) for numerous reasons although PSC is uncommon. Given the known increased risk of colorectal cancer in patients with both UC and PSC as well as cholangiocarcinoma, early recognition of PSC is crucial. <h3>Methods</h3> Aims: To identify known patients with UC from our clinic population who also had persistently elevated LFTs and to determine the extent to which the cause of the abnormal LFTs had been investigated. <h3>Methods</h3> A representative sample of patients with UC was identified from those who had contacted the nurse led IBD telephone help line at Gloucestershire Hospitals NHS Foundation Trust during September and October 2010. UC diagnosis was based on histology proven on biopsies including colectomy. Abnormal LFTs were defined as a persistent elevation above the local laboratory upper limit of normal (ALT &gt;40 IU/l, ALP &gt;200 IU/l, GGT &gt;30 IU/l and bilirubin &gt;17 mmol/l). The investigations performed to identify the cause of the abnormalities were noted. <h3>Results</h3> A total of 450 phone calls were made to the IBD help line during the study period. Of those, 82 patients with ulcerative colitis were identified. Of these, 15 patients (18.3%) had so far been found to have abnormal LFTs at some time during the course of their illness. Persistently abnormal LFTs were identified in 10 patients (12.2%). Of these 10, 6 (60%) had auto immune screen, four patients (40%) had viral hepatitis screen, four patients (40%) had a liver ultrasound, three patients (30%) had CT abdomen. Furthermore no patients had targeted investigations to exclude PSC such as a liver biopsy or magnetic resonance cholangiography. <h3>Conclusion</h3> Our results suggest that 12% of ulcerative colitis patients in our cohort had persistently abnormal liver function tests although none had had further investigations for PSC. Given expected prevalence data we could perhaps expect to see one patient with PSC in this cohort. The monitoring and following of LFTs in patients with UC should be part of standard follow-up procedures. <h3>Competing interests</h3> None declared. <h3>References</h3> 1. <b>Chapman R</b>, Fevery J, Kalloo A, <i>et al.</i> Diagnosis and management of primary sclerosing cholangitis. <i>Hepatology</i> 2010;<b>51</b>:600–78. 2. <b>Tishendorf JJW</b>, Geier A, Trautwein C. Current diagnosis and management of primary sclerosing cholangitis. <i>Liver Transplantation</i> 2008;<b>14</b>:735–46.