tbuckley/cabot-search huggingface dataset:
Surgeon who alleged constructive dismissal over bullying loses case
Authors: O. Dyer
Journal: BMJ (2003)

A surgeon who threw a dessert spoon in an operating theatre lost his case before an Exeter employment tribunal this week. Consultant orthopaedic surgeon Godfrey Charnley, aged 43, threw the spoon away in disgust when it was offered to him as an alternative surgical instrument.

Mr Charnley resigned from Plymouth's Derriford Hospital in December 2001. He told the tribunal that hospital managers who were obsessed with meeting government waiting list targets fostered a culture of bullying and intimidation and compromised the quality of patient care. He argued that the pressure brought on him amounted to constructive dismissal.

Mr Charnley said the investigation into the spoon incident was …
Coronary artery bypass grafting for the reduction of mortality: an analysis of the trials
Authors: J R Hampton
Journal: BMJ (1985)

Economies in the NHS SIR,-If Mr Fowler is keen on economies in the NHS he should look no further than the Welsh Office where before DHSS circulars are forwarded to family practitioner com- mittees, district health authorities, local medical committees, community health councils, etc, they are retyped on Welsh Office stationery.The Welsh Office also changes the reference numbers and dutifully corrects references within the circular so that it conforms to previous Welsh Office modi- fications to old DHSS circulars.The result of all this bureaucratic nonsense is unnecessary expense, delay, and chaos.We frequently learn of changes to regulations in the medical press but are then informed by the Welsh Office that these changes do not apply to Wales until the appropriate circular has been released.During reorganisation some of these circulars were delayed for up to six months.About six years ago, as an LMC secretary, I received, with a covering letter from the FPC, a photostat of a letter from the DHSS to the Welsh Office, a photostat of a letter from the Welsh Office to the FPC, and a modified Welsh Office circular, informing us that the drug tariff book would be delayed through lack of paper.The recent circular concerning the new regulations controlling barbiturate drugs, which came into effect on 1 January 1985, was not received by our FPC for redistribution until 15 January 1985.As usual, chaos reigned as pharmacists were refusing to dispense prescriptions issued before we were notified of the regulation change.As all DHSS circulars refer equally to England and Wales, there would be a resultant increase in efficiency and reduction in ex- penditure if all these circulars were sent out directly by the DHSS.No doubt similar economies could be made in Scotland and Northern Ireland.
Health minister will improve Aboriginal health care
Authors: C Zinn
Journal: BMJ (1994)

Australia's poor record on Aborginal Health issues (8 January, pp 77) is about to be tackled head on by the federal minister for health, Senator Graham Richardson. While touring remote Aborginal settlements in the Northern Territory Senator Richardson promised to make health care the key components of a new social justice package being negotiated with Aborginies.

The minister said that he had encountered living …
Penicillamine in rheumatoid arthritis: comparison of two dose schedules [proceedings].
Authors: A G Hill, H F Hill
Journal: Annals of the Rheumatic Diseases (1976)

Heberden Society 541 tuberculous arthritis, to gout, or to a variant of the socalled seronegative peripheral arthritis as seen in Reiter's disease, arthritis associated with gastrointestinal disease, psoriasis, and ankylosing spondylitis.In all these con- ditions, however, the involvement of the proximal inter-
Abstract 3795: Vangl2 and Prickle1 expression, interaction and regulation of Wnt/PCP signaling in medulloblastoma and neuroblastoma.
Authors: Cecilia H. Dyberg, Panagiotis Papachristou, Hugo Lagercrantz, John I Johnsen, Malin Wickström
Journal: Cancer Research (2013)

Abstract Background /Aims: Wnt are a family of intercellular signaling factors that regulates a wide range of functions during embryonic development including cell proliferation, cell fate determination, differentiation, cell polarity and cell migration. They bind to Frizzled receptors and thereafter proceed via Dishevelled to several intracellular pathways known as the canonical and non-canonical signaling pathways. Activation of the canonical pathway results in an accumulation of cytoplasmic beta-catenin levels. Increased Wnt/beta-catenin signaling is associated with many forms of cancer, including the embryonic neural childhood tumors medulloblastoma and neuroblastoma. The non-canonical Wnt signaling pathways can inhibit the canonical signaling pathway, although the mechanism is still unclear. In this study, we investigate the roles of Prickle1 and Van Gogh-Like 2 (Vangl2), two planar cell polarity (PCP) genes in regulation of the cytoskeleton, Wnt/beta-catenin activity and tumorigenicity in neuroblastoma and medulloblastoma. Methods: mRNA and protein expression of human Prickle1, Vangl2 and beta-catenin were examined in neuroblastoma and medulloblastoma cell lines. siRNA and cDNA transfection were performed together with co-immunoprecipitation and immunocytochemistry. Results and conclusions: We show that Prickle1 and Vangl2 are expressed in neuroblastoma and medulloblastoma cell lines at different levels. Decreased Prickle1 expression correlates with increased levels of Wnt/beta-catenin in both medullo- and neuroblastoma cell lines, demonstrating a downregulation of PCP components and a possible activation of the canonical Wnt signaling pathway. Immunoprecipitation demonstrated that Prickle1 is present in complex with Vangl2. However, the exact mode of interaction between Prickle1 and Vangl2 remains to be eluciated. Microarray analysis revealed that low expressions of Prickle1 or Vangl2 are both associated significantly worse clinical outcome in neuroblastoma. Additionally, siRNA experiments revealed that knockdown of Prickle1 and Vangl2 increased cell proliferation of neuroblastoma cells. Taken together this indicate that the non-canonical Wnt pathway may be an interesting therapeutic target in embryanol neural childhood tumors. Citation Format: Cecilia H. Dyberg, Panagiotis Papachristou, Hugo Lagercrantz, John I Johnsen, Malin Wickström. Vangl2 and Prickle1 expression, interaction and regulation of Wnt/PCP signaling in medulloblastoma and neuroblastoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3795. doi:10.1158/1538-7445.AM2013-3795
Is lipid peroxidation relevant to atherogenesis?
Authors: Jay W. Heinecke
Journal: Journal of Clinical Investigation (1999)

Many lines of evidence suggest that LDL, the major carrier of blood cholesterol, becomes atherogenic as a result of oxidation (reviewed in refs. 1–3). One of the most persuasive observations is that structurally unrelated lipid-soluble antioxidants inhibit atherogenesis in animal models of hypercholesterolemia. For example, probucol, butylated hydroxytoluene, and N,N′-diphenyl-phenylenediamine all inhibit LDL oxidation in vitro, and retard the progression of atherosclerosis in hypercholesterolemic rabbits, mice, and quail. Moreover, probucol exerts a significant effect on thoracic atherosclerosis in primates with diet-induced hypercholesterolemia. These observations may be relevant to human disease, because a recent clinical trial of vitamin E suggests that antioxidant therapy inhibits the clinical sequelae of atherosclerosis (4).
Geriatrics Residency and Fellowship Programs
Authors: Knight Steel
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Prior to 1970, there were only occasional geriatrics courses offered in medical schools and relatively little interest in the practice of geriatric medicine.<sup>1</sup>In 1972, this country's first formal geriatrics residency program was initiated at the Mount Sinai City Hospital Center in New York.<sup>2</sup>Impressive progress has been made in instituting residencies and fellowships in geriatric medicine during the past 12 years. Biennially since 1980, the American Geriatrics Society, in cooperation with the Boston University Gerontology Center, has surveyed the medical schools in the United States and Canada to compile the data for the<i>Directory of Geriatrics Programs for Residencies and Fellowships</i>. A summary of the contents of the three editions of the<i>Directory</i>(April 1980, April 1982, and January 1984) demonstrates the progress that has been made in establishing programs (Table 1). Actual geriatrics fellowship programs in the United States numbered 44 in 1982
City Hospital in Wheeling.
Authors: S. L. Jepson
Journal: JAMA (1894)

Wheeling, W. Va., Dec. 14,1894. <h3>To the Editor:</h3> —For many years, Wheeling had but one hospital, the Wheeling Hospital, which is owned and controlled by the Catholic church. It has never had a regular medical and surgical staff, nor any special provision for charity cases, although at times such cases are received, especially in emergencies. For many years the late Dr. John Frissell did most of the work, both medical and surgical at this institution, of which he was really the founder. His son, Dr. C. M. Frissell, and Dr. G. Ackermann, are his successors, although any physician may attend his own private cases there. About three years ago another hospital was opened under Protestant auspices, in the hope of providing still more liberally for the treatment of the sick poor. A large building formerly used as a female seminary was purchased, and with some changes was made to serve
Letter: Withdrawal symptoms in newborn infants of epileptic mothers.
Authors: M J Erith
Journal: BMJ (1975)

understand immunity to erytshocytic malaria, and it is far from simple.What we just do not know is how to identify and produce in bulk the appropriate antigen(s) of experi- mental malarias, let alone of P. falciparum and other human parasites.Nor do we know -how to present these antigens in a way which stimulates the inmnune system to best advantage without using Draconian adjuvants like F.CA.When we have solved these fomidable problems a practical vaccine in- corprating blood stage antigens might become feasible.-Iam, etc.,
Tetralogy of Fallot with Anomalous Tricuspid Valve Simulating Pulmonary Stenosis with Intact Septum
Authors: HENRY N. NEUFELD, DWIGHT C. MCGOON, JAMES W. DUSHANE, JESSE E. EDWARDS
Journal: Circulation (1960)

An anatomicopathologic entity of the tetralogy of Fallot with an additional finding of an accessory flap of tricuspid valvular tissue is described. In the 3 cases reported in this paper, the outstanding hemodynamic finding was a right ventricular systolic pressure that was significantly greater than the systemic systolic pressure. The hemodynamic findings were explained by the fact that the accessory tricuspid flap partially closed the large ventricular septal defect. The clinical picture was similar to that of either severe pulmonary stenosis with an intact ventricular septum or severe pulmonary stenosis with a small ventricular septal defect and a right-to-left shunt at the ventricular level.
Patient-centered communication
Authors: Debra Roter
Journal: BMJ (2004)

More than a string of words 

The study by Wright and colleagues in this issue of BMJ USA (p 303) presents the perspectives and experience of a small sample of patients with breast cancer as they engaged in the care process with their physicians. As the investigators note, their conclusions depart in substantial ways from current knowledge regarding the positive effects of patient-centered communication in oncology visits. In an attempt to understand how so dramatic a departure from the literature may be explained, conceptual weaknesses of the study and its interpretation of findings—rather than limitations of the established literature—have emerged. The investigators' primary conceptual errors were equating isolated segments of the medical dialogue with meaningful representations of communication skill, and further, attributing the source of perceived relationship characteristics to patients' dependency needs rather than to communication.

The method of inquiry and sources of data for the study were unusual. Women with primary breast cancer, ranging in disease stage from histological diagnosis after surgery to follow-up …
A6-02: A novel heterozygous germline mutation of NBS1 leading to loss of the MRE11-binding domain predisposes to common types of cancers
Authors: Hiromichi Ebi, Keitaro Matsuo, Nobuyoshi Sugito, Motoshi Suzuki, Hirotaka Osada, Kazuo Tajima, Ryuzo Ueda, Takashi Takahashi
Journal: Journal of Thoracic Oncology (2007)
Changing Blood Types and Other Immunohematologic Surprises
Authors: Lawrence D. Petz, Loni Calhoun
Journal: New England Journal of Medicine (1992)

CHANGES in blood type have been described in a variety of illnesses, usually acute infections or neoplasms.1 With the advent of transplantation of bone marrow and solid organs, a growing number of unexpected immunohematologic findings have been noted, especially when the donor and recipient are of different ABO blood groups. In this issue of the Journal, Comenzo et al.2 add to the list of anomalies by describing a patient whose blood type transiently changed from group O to group AB after transplantation of a liver from a group AB donor.Several explanations for an apparent change from group O . . .
LOCAL SULFONAMIDE THERAPY IN ACUTE MASTOIDITIS
Authors: GEORGE S. LIVINGSTON
Journal: JAMA (1941)

The local use of sulfanilamide and its related compounds is increasing rapidly, as indicated by numerous reports in the recent literature. Jensen, Johnsrud and Nelson<sup>1</sup>implanted sulfanilamide crystals in 39 cases of compound fracture and 2 compound dislocations after careful débridement and hemostasis, followed by primary closure of the skin, with no primary wound infection. In 94 similarly treated cases, but without sulfanilamide, 27 per cent showed infection. Key and Burford<sup>2</sup>had a similar experience with compound fractures. They noted also that experimentally produced fractures in rabbits treated locally with sulfanilamide showed as rapid wound and bone healing as those in which the drug was not used. Campbell and Smith<sup>3</sup>treated 54 compound fractures, using sulfanilamide both locally and by mouth. Mueller<sup>4</sup>used it in the peritoneal cavity in 55 cases of abscess and peritonitis following ruptured appendixes, with no mortality. Many other reports have appeared
Occurrence of delirium is severely underestimated in the ICU during daily care
Authors: Peter E. Spronk, Bea Riekerk, José Hofhuis, Johannes H. Rommes
Journal: Intensive Care Medicine (2009)

Delirium is associated with prolonged intensive care unit (ICU) stay and higher mortality. Therefore, the recognition of delirium is important. We investigated whether intensivists and ICU nurses could clinically identify the presence of delirium in ICU patients during daily care.All ICU patients in a 3-month period who stayed for more than 48 h were screened daily for delirium by attending intensivists and ICU nurses. Patients were screened independently for delirium by a trained group of ICU nurses who were not involved in the daily care of the patients under study. The Confusion Assessment Method for the ICU (CAM-ICU) was used as a validated screening instrument for delirium. Values are expressed as median and interquartile range (IQR; P25-P75).During the study period, 46 patients (30 male, 16 female), median age 73 years (IQR = 64-80), with an ICU stay of 6 days (range 4-11) were evaluated. CAM-ICU scores were obtained during 425 patient days. Considering the CAM-ICU as the reference standard, delirium occurred in 50% of the patients with a duration of 3 days (range 1-9). Days with delirium were poorly recognized by doctors (sensitivity 28.0%; specificity 100%) and ICU nurses (sensitivity 34.8%; specificity 98.3%). Recognition did not differ between hypoactive or active status of the patients involved.Delirium is severely under recognized in the ICU by intensivists and ICU nurses in daily care. More attention should be paid to the implementation of a validated delirium-screening instrument during daily ICU care.
Leukocytic Muscular Dystrophy
Authors: Peter A. Ward
Journal: New England Journal of Medicine (1974)

That leukocytes arrive at extravascular sites by migrational responses is not seriously doubted. Precisely what signals cells to emigrate from the vasculature is unclear, but there is increasing evidence that chemotactic mediators play an important part. If generation of these mediators is blocked, if inhibitors are present that are directed against chemotactic mediators or leukocytes, or if familial or acquired defects render leukocytes unable to respond effectively to chemotactic or phagocytic stimuli, the possessor of any of these abnormalities will be at risk in coping with bacterial infections. Examples of cell-associated defects in which leukotactic or phagocytic functions are impaired . . .
Bureaucracy of ethics applications
Authors: David S Wald
Journal: BMJ (2004)

match the research design, and advised on qualitative data analysis (which the researchers were unfamiliar with) and resubmission to the ethics committee.To minimise disruption, funding was continued to allow the research team to develop the protocol and patient information sheets before resubmission.If the researchers had expressed concern that this represented misuse of resources, the funding could have been re-profiled.Trust approval was given two months later for the pilot research project to restart, after a favourable opinion from the research ethics committee.Subsequently, we worked with the researchers to provide funding to extend their data collection and analysis.Introduction of a qualitative component represents an important change to a study, originally peer reviewed and funded as a quantitative study.Research participants have a right to be presented with accurate and complete information when being asked for informed consent.However, further public debate is needed on research governance measures implemented in the NHS-for example, on linking research project management more closely with risk assessment.Such public debate will help ensure that NHS research is conducted according to research governance and ethical standards.
Human erythroleukemia: is the two-hit model of mouse leukemogenesis valid in human disease?
Authors: S Coulon, J Vandekerckhove, M Dussiot, C Callens, F Suarez, J Kersual, V Asnafi, Z Belaid, G Courtois, S Giraudier, P Dubreuil, Y Lepelletier, I C Moura, O Hermine
Journal: Leukemia (2007)
Residual Ductal Carcinoma In Situ in Patients With Complete Eradication of Invasive Breast Cancer After Neoadjuvant Chemotherapy Does Not Adversely Affect Patient Outcome
Authors: Chafika Mazouni, Florentia Peintinger, Shu Wan-Kau, Fabrice Andre, Ana M. Gonzalez-Angulo, W. Fraser Symmans, Funda Meric-Bernstam, Vicente Valero, Gabriel N. Hortobagyi, Lajos Pusztai
Journal: Journal of Clinical Oncology (2007)

To determine whether residual ductal carcinoma in situ (DCIS) after completion of preoperative chemotherapy affects the outcome of patients with histologically defined complete eradication of invasive cancer.Retrospective analysis of a database including 2,302 breast cancer patients treated with neoadjuvant chemotherapy at The University of Texas M.D. Anderson Cancer Center between 1980 and 2004 was performed. The overall survival (OS), disease-free survival (DFS), and local recurrence-free survival were compared for patients with no residual invasive or in situ cancer (pathologic complete response [pCR]) and patients with no residual invasive cancer but persistent in situ disease (pCR+DCIS).The mean follow-up time was 250 months. Of the 2,302 treated patients, 78 (3.4%) had pCR, 199 (8.6%) had pCR+DCIS, and 2,025 (88%) had residual invasive cancer. For patients with pCR and pCR+DCIS, the 5-year DFS rates (87.1% in both groups) and 10-year DFS rates (81.3% v 81.7%, respectively) were similar; the 5-year OS rates (91.9% v 92.5%, respectively) and 10-year OS rates (91.8% v 92.5%, respectively) were also similar and significantly better than the rate of patients with residual invasive cancer (74.4%; P < .001). The 5-year locoregional recurrence-free survival rates were also not different between patients with pCR (92.8%; 95% CI, 86.1% to 96.4%) and patients with pCR+DCIS (90.9%; 95% CI, 77.3% to 96.5%; P = .63).Residual DCIS in patients who experience complete eradication of the invasive cancer in the breast and lymph nodes does not adversely affect survival or local recurrence rate. Inclusion of patients with residual DCIS in the definition of pCR is justified when this outcome is used as an early surrogate for long-term survival.
Abstract 1818: Identification of men with a genetic predisposition to prostate cancer: Targeted screening of <i>BRCA1/2</i> mutation carriers and controls; The IMPACT study
Authors: Elizabeth K. Bancroft, Elena Castro, Elizabeth C. Dalby, Rosalind A. Eeles
Journal: Cancer Research (2011)

Abstract Introduction: Men with a mutation in either the BRCA1 or BRCA2 gene have an increased risk of prostate cancer, estimated as 3-5% for BRCA1 and up to 20% for BRCA2 by age 70. It has been demonstrated that men with BRCA2 develop aggressive disease but the real incidence and prevalence of cancer in mutation carriers remains unknown. IMPACT is a multi-national targeted prostate cancer screening study of men with a known germline mutation which is thought to predispose to the disease. The study is recruiting male BRCA1/2 mutation carriers and a control group who have tested negative for a mutation present in their family from 37 centres in 14 countries. The aims of the study are to establish an international targeted prostate cancer screening in BRCA1 and BRCA2 mutation carriers; to determine the sensitivity and specificity of PSA screening for prostate cancer in this group; to determine the incidence of abnormal biopsy as a result of PSA screening in this group and to determine whether the pathology of tumours is different from screen-detected disease in controls. Method: Eligible men aged 40-69 years are offered annual serum PSA testing for five years. The PSA threshold used to determine prostate biopsy is &amp;gt;3ng/ml. All men are offered a biopsy irrespective of PSA level after 5 years of screening. Men are also invited to take part in a Quality of Life sub-study. Results: To date 1000/1700 men have been recruited, 77 have undergone biopsy and 30 men have been diagnosed with prostate cancer (18 BRCA2 carriers, 7 BRCA1 carriers and 5 controls). 80% of cases diagnosed in BRCA1/2 carriers were Gleason score ≥7 and T2 or higher (in the intermediate/high risk group for immediate radical treatment and not active surveillance, according to NICE guidelines) while in the general population (ERSPC study), 72% had a Gleason ≤6 and 61% were T1 (low risk group, suitable for active surveillance). The estimated positive predictive value for PSA screening in BRCA carriers is 44% vs 24% in the general population (ERSPC study). Conclusions: Our preliminary results show that annual PSA screening using a cut-off of 3.0ng/ml detects aggressive prostate cancer in BRCA1/2 carriers. The higher risk of PrCa observed in BRCA1 and BRCA2 carriers will need to be confirmed with further data. Early data indicate that a larger proportion of gene carriers have developed clinically significant prostate cancers (those that would need radical treatment on UK treatment guidelines) compared with the control group. 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 1818. doi:10.1158/1538-7445.AM2011-1818