tbuckley/cabot-search huggingface dataset:
PTU-245 Community based specialist gastroenterology clinic in Sheffield, UK—comparing primary care and secondary care based clinics 2010–2011
Authors: L Strettle, A Abdulrehman, M E Sloan, M E McAlindon, A J Lobo
Journal: Gut (2012)

<h3>Introduction</h3> Community based clinics may improve patients9 access to healthcare and improve communication between primary and secondary care.<sup>1</sup> A community gastroenterology clinic was established in Sheffield in 2011 to deliver out-patient care closer to patients9 homes while retaining access to specialist expertise. This study reports results from the first 8 months of the community clinic and compares with secondary care gastroenterology clinics. <h3>Methods</h3> A single, weekly, consultant-delivered new patient community clinic (CC), designed as a “one touch”, single consultation, was established in primary care for a Consortium of 27 General Practices. Data for the study period, March 2011–October 2011, was retrieved for the CC from referral proformas, letters and primary care records. This was compared to secondary care clinics for patients9 referred from the same consortium during the study period and for the same time period the year prior to the CC (March 2010 to October 2010). <h3>Results</h3> In March–October 2010, 579 patients from the consortium were seen in secondary care gastroenterology clinics. During March–October 2011, 896 patients were seen in gastroenterology clinics: 741 (82%) in secondary care and 155 (18%) in the newly established CC. Mean age was lower in the CC (50 vs 57.8 years, p&lt;0.001), with 42/155 (27%) aged over 65 in the CC compared to 310/741 (42%) in the secondary care clinic (p&lt;0.01). 67/741 (9.0%) patients did not attend appointments at the secondary care clinic compared to 9/155 (5.8%; p=0.15) in the CC. Median waits for CC appointments was 21 days at month 1 rising to 47.5 days in month 8. Presenting features were altered bowel habit (n=59 (38%)), abdominal pain (n=23 (15%)), reflux type dyspepsia (n=18 (12%)) and iron deficiency anaemia (n=16 (10%)). 144 patients (93%) attending the CC had had the specified pre-clinic investigations. 118/146 (81%) patients attending the CC were discharged back to the GP after one visit: of whom 111 (94%) had further tests recommended (33 blood tests, 56 gastroscopy, 53 colonoscopy, 16 ultrasound abdomen). In the 2010 period prior to the CC, 35/579 (6%) patients seen were discharged from their initial secondary care clinic review (p&lt;0.0001). <h3>Conclusion</h3> The new primary care gastroenterology clinic is associated with higher initial discharge rates, moving co-ordination of ongoing out-patient management to primary care. However, this was not associated with a reduction in patients seen in secondary care and attracted a younger cohort of patients. Additional follow-up is required to assess effects on overall healthcare resource utilisation. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Powell J</b>. Systematic review of outreach clinics in primary care in the UK. <i>J Health Serv Res Policy</i> 2002;<b>7</b>:177–83.
The Role of Hyaluronan Synthase 3 in Ventilator-induced Lung Injury
Authors: Kuan-Jen Bai, Andrew P. Spicer, Marcella M. Mascarenhas, Lunyin Yu, Cristhiaan D. Ochoa, Hari G. Garg, Deborah A. Quinn
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

We recently found that low-molecular-weight hyaluronan was induced by cyclic stretch in lung fibroblasts and accumulated in lungs from animals with ventilator-induced lung injury. The low-molecular-weight hyaluronan produced by stretch increased interleukin-8 production in epithelial cells, and was accompanied by an upregulation of hyaluronan synthase-3 mRNA. We hypothesized that low-molecular-weight hyaluronan induced by high VT was dependent on hyaluronan synthase 3, and was associated with ventilator-induced lung injury. Effects of high VT ventilation in C57BL/6 wild-type and hyaluronan synthase-3 knockout mice were compared. Significantly increased neutrophil infiltration, macrophage inflammatory protein-2 production, and lung microvascular leak were found in wild-type animals ventilated with high VT. These reactions were significantly reduced in hyaluronan synthase-3 knockout mice, except the capillary leak. Wild-type mice ventilated with high VT were found to have increased low-molecular-weight hyaluronan in lung tissues and concomitant increased expression of hyaluronan synthase-3 mRNA, neither of which was found in hyaluronan synthase-3 knockout mice. We conclude that high VT induced low-molecular-weight hyaluronan production is dependent on de novo synthesis through hyaluronan synthase 3, and plays a role in the inflammatory response of ventilator-induced lung injury.
Gastric-Outlet Obstruction in Children
Authors: Peter J. Milla
Journal: New England Journal of Medicine (1992)

Gastric-outlet obstruction in infants causes vomiting of such persistence that the loss of fluid and electrolytes may be life-threatening. The causes of gastric-outlet obstruction include relatively common disorders, such as hypertrophic pyloric stenosis, as well as uncommon congenital neuromuscular disorders, pyloric atresia, and antral webs. In older children and adults, pyloric obstruction may also be caused by acquired neuromuscular disease (for example, from diabetes mellitus) or by fibrosis (for example, after inflammation in patients with peptic ulceration). Each of these conditions originates in the mucosa, the smooth-muscle layers, or the intrinsic innervation of the gastric antrum, the pylorus, or the . . .
A patient's charter for laboratories.
Authors: S. Bulusu, C. M. Royce
Journal: BMJ (1992)

situation.The consumer is reasonably happy with it, it is politically acceptable, and it is probably more equitable.It does, however, mean that we must accept the inevitability of waiting lists as a method of rationing.Well managed waiting lists, for all their prob- lems, are a good method of rationing.They are explicit and can be regulated to ensure that they are equitable.Furthermore, they are reasonably acceptable to the public: far better to be on a waiting list than to be told that an operation on the NHS will never be done under any circumstances.Our view is that economic dogma has held sway for too long in health care.Yet when the hard decisions are being made in health authorities and health boards the dogmatists are nowhere to be seen.We should now formalise the social model of resource allocation along lines that have been suggested previously.'With this method economic appraisal is but one of the four variables-with government priorities, consumer opinion, and formal needs assessment -that determine resource allocation.We would thus ensure that the NHS was, as Smyth puts it, "an element of the national apparatus of justice."
Postural Stability in Diabetic Polyneuropathy
Authors: Pierre Boucher, Normand Teasdale, Richard Courtemanche, Chantal Bard, Michelle Fleury
Journal: Diabetes Care (1995)

OBJECTIVE To examine whether sensory changes in lower limbs associated with diabetic sensory polyneuropathy compromise postural stability in different visual sensory conditions. RESEARCH DESIGN AND METHODS The presence and seventy of sensory neuropathy was evaluated with a clinical scale and measures of nerve conduction velocity in the lower limbs. Balance control was evaluated by testing subjects' postural stability (with a force platform) with vision, without vision, and during a recovery period after being without vision. RESULTS Neuropathic patients showed larger ranges of sway, a faster sway speed, and a greater dispersion of sway than control subjects in all conditions. They also exhibited similar or less stable postural performance with vision than that of control subjects without vision. There was a strong relationship between the severity of the neuropathy and the postural stability. CONCLUSIONS This experiment highlights that even with vision, the postural stability of neuropathic patients is impaired and may put them at higher risk of falling when performing more challenging daily tasks.
Spread of &lt;EMPH TYPE="ITAL"&gt;Mycobacterium tuberculosis&lt;/EMPH&gt; in a Community Implementing Recommended Elements of Tuberculosis Control
Authors: Daniel P. Chin
Journal: JAMA (2000)

Despite improvements in tuberculosis (TB) control during the past decade, Mycobacterium tuberculosis transmission and resulting disease continue to occur in the United States.To determine the primary reasons for disease development from a particular strain of M tuberculosis.Population-based, molecular epidemiological study.Urban community in the San Francisco Bay area of California with recommended elements of TB control in place.Seventy-three TB cases were reported in 1996-1997 that resulted from 1 strain of M tuberculosis as identified by TB genotyping and epidemiological linkage.Transmission patterns involving source and secondary case-patients; primary reasons for disease development.Seventy-three (33%) of 221 TB case-patients in this community resulted from this strain of M tuberculosis. Thirty-nine (53%) of the 73 case-patients developed TB because they were not identified as contacts of source case-patients; 20 case-patients (27%) developed TB because of delayed diagnosis of their sources; and 13 case-patients (18%) developed TB because of problems associated with the evaluation or treatment of contacts; and 1 case-patient (1%) developed TB because of delay in being elicited as a contact. Of the 51 TB cases identified with sources, 49 (96%) were infected within the 2 years prior to diagnosis.Our results indicate that in a community that has implemented the essential elements of TB control, TB from ongoing transmission of M tuberculosis will continue to develop unless patients are diagnosed earlier and contacts are more completely identified. JAMA. 2000.
Serotonin Mediates Cross-Modal Reorganization of Cortical Circuits
Authors: Susumu Jitsuki, Kiwamu Takemoto, Taisuke Kawasaki, Hirobumi Tada, Aoi Takahashi, Carine Becamel, Akane Sano, Michisuke Yuzaki, R. Suzanne Zukin, Edward B. Ziff, Helmut W. Kessels, Takuya Takahashi
Journal: Neuron (2011)
The Controlled Drinking Controversy
Authors: Vernelle Fox
Journal: JAMA (1976)

Alcoholism is a complex set of disorders manifested by abusive drinking. It can be the result of cultural dependency, physical addiction, or psychological dependency on the drug. By the time most people suffer enough to overcome the stigma surrounding the illness and look for help, they have some of all three dependencies at work. Writers have been describing "the alcoholisms" as a complex set of disorders with multiple etiologies for years. Serious workers in the field frequently state this fact and then proceed to write and act as if there were a single illness called alcoholism. This inconsistency has had a new upsurge lately over two major issues: (1) research aimed at establishing the possibility of controlled drinking in selected patients, and (2) abstinence as a major criterion for success in treatment. Even though we state that the label "alcoholism" is given to several disabilities, some workers become quite upset
PART-TIME MEDICAL OFFICERS OF HEALTH
Authors: J. S. Walker
Journal: BMJ (1910)

<h3>Abstract</h3> Deep proteomics profiling using labeled LC-MS/MS experiments has been proven to be powerful to study complex diseases. However, due to the dynamic nature of the discovery mass spectrometry, the generated data contain a substantial fraction of missing values. This poses great challenges for data analyses, as many tools, especially those for high dimensional data, cannot deal with missing values directly. To address this problem, the NCI-CPTAC Proteogenomics DREAM Challenge was carried out to develop effective imputation algorithms for labeled LC-MS/MS proteomics data through crowd learning. The final resulting algorithm, DreamAI, is based on an ensemble of six different imputation methods. The imputation accuracy of DreamAI, as measured by Pearson correlation, is about 15%-50% greater than existing tools among less abundant proteins, which are more vulnerable to be missed in proteomics data sets. This new tool notably enhances data analysis capabilities in proteomics research.
Abstract 87: Micropapillary breast carcinoma is characterized by deregulation of genes involved in cell division control
Authors: Nadege Gruel, Vanessa Benhamo, Tatiana Popova, Arnaud Gauthier, Ilaria Cascone, Laurent Arnould, Paul Fréneaux, Aurelie Cedenot, Odette Mariani, Jaydutt Bhalshankar, Gaëlle Pierron, Patricia de Cremoux, Fabien Reyal, Severine Alran, Paul Cottu, Alain Fourquet, Xavier Sastre, Marc-Henri Stern, Jacques Camonis, Olivier Delattre, Anne Vincent-Salomon
Journal: Cancer Research (2012)

Abstract This study provides insight into the biological specificities of invasive micropapillary carcinoma of the breast (IMPC), an entity characterized by cell polarity inversion and frequent lymphovascular invasion and axillary lymph node metastasis compared to invasive ductal carcinoma (IDC). Morphological review was combined with copy number analyses, genotyping (SNP6.0 Affymetrix), TP53 and PIK3CA sequencing and transcriptomic analysis in a series of 39 pure IMPC and the results were compared to those of 19 IDC with positive estrogen receptors, and positive axillary lymph node and lymphovascular invasion (ER+, N+, LVI+). The presence of numerous bi-nucleated cells was identified as a morphological pattern of IMPC. This specific trait was underlined by deregulation of the expression of genes involved in cell division. IMPC and IDC exhibit common genomic alterations including 8p-, 8q+, 16q-, 17p13- and 22q- and mutations of PIK3CA (10% for IMPC and 11% for IDC) and TP53 (13% in IMPC vs 33% in IDC). In contrast, IMPC were specifically characterized by frequent 17q23.2-q24.1 gains (54%), chromosomes 17q 23.1 (26%), 17q12 (22%), 8q22.1 (21%) amplifications and 6q16.1-q22.31 losses (43%). Within the IMPC group, unsupervised analysis of genomic data distinguished two distinct subsets: one subset (16 IMPC) exhibited a significant increase in 16p gains associated with near-diploid cells and the second subset (19 IMPC) characterized by a high frequency of 8q, 17q and 20q amplifications associated with near-tetraploid cells. This analysis showed that IMPC constitutes a distinct entity from ER+ N+ LVI+ IDC with, in particular, high frequencies of bi-nucleated cells, 17q gains and amplifications associated with 6q losses of heterozygosity. This study also showed that IMPC comprises two genomic subsets that may suggest the existence of different oncogenic mechanisms giving rise to the same morphological entity. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 87. doi:1538-7445.AM2012-87
Good quality partner notification should not compromise rights to confidentiality in HIV
Authors: S. Radcliffe
Journal: BMJ (2013)

Balancing the competing duties of maintaining privacy in a doctor-patient relationship with minimising potential harm caused by non-disclosure of HIV status is not easy.1 The National AIDS Trust does not believe the problem will be resolved by reducing confidentiality rights. It is easy to characterise the behaviour of hypothetical patients as selfish and objectionable, but this simple moralistic …
The Moral of the Story
Authors: Perri Klass
Journal: New England Journal of Medicine (2008)

I came home the other night clutching a scrap of paper towel with a mother's cell-phone number scribbled on it. I had been precepting in the residents' pediatric primary care clinic, and an intern had presented a patient: a 20-month-old boy who had been brought in by his mother because he was vomiting. He'd thrown up seven times since 2 that morning. No diarrhea, but he wasn't eating or drinking much. Still, he didn't look dehydrated, his mother said he'd had several wet diapers, and when the intern examined him, she found his diaper wet again.The intern said he . . .
Prostaglandins in human skin disease
Authors: C.N. HENSBY, B. SHROOT, H. SCHAEFER, L. JUHLIN, J.P. ORTONNE
Journal: British Journal of Dermatology (2006)

A variety of different, experimentally induced human skin inflammatory stimuli including UV‐A (Barr et al., 1982a; Gilchrest et al., 1982), UV‐B (Black et al., 1978, 1980; Hensby et al., 1980; Black, Hensby & Greaves, 1982), UV‐C (Camp et al., 1978), infra‐red (Hensby et al., 1982), trafuril (Plummer et al., 1977) and anthralin (Barr et al., 1982b) cause marked and prolonged elevations of the recoverable levels of arachidonic acid and its cyclo‐oxygenase products. The known pharmacology of many prostanoids (products of the prostaglandin cyclo‐oxy‐genase system) including vasodilatation and synergism with other inflammatory mediators (Hensby, Kingston & Greaves, 1976; Camp, 1982) would suggest a role for prostanoids in various human skin diseases, particularly those associated with an inflammatory component. We now report the preliminary results that we have obtained for the recoverable levels of four prostanoids, namely PGE2, PGD2, PGF2x, and 6‐oxo‐PGF1x in four human skin disorders, viz. psoriasis, tuberculin delayed hypersensitivity, vitiligo and scleroderma.
A patient who changed my practice: Out of hours
Authors: A. Munno
Journal: BMJ (1998)

I hated home visits as a young GP, especially those that were requested out of surgery hours. The ring of the telephone elicited a Pavlovian response of panic and irritation. The panic, I think was a residue of my time as a junior hospital doctor, when there was always a fear that the next call I had would be to a situation I could not cope with. The irritation came as the panic settled and I was left to deal with a complaint that was often trivial or …
Nephron supply is a major determinant of long-term renal allograft outcome in rats.
Authors: H S Mackenzie, S G Tullius, U W Heemann, H Azuma, H G Rennke, B M Brenner, N L Tilney
Journal: Journal of Clinical Investigation (1994)

The effects of augmenting the nephron supply on indices of allograft injury were assessed in a rat model of "chronic rejection." Orthotopic renal allotransplantation into unine-phrectomized rats was followed by excision (allograft-alone group) or preservation of the remaining native kidney (allograft+native kidney group) such that the total kidney complement was either the allograft alone, or the allograft plus one retained native kidney. After 18 wk, values for GFR (1.85 +/- 0.3 ml/min) and kidney weights (2.3 +/- 0.2 g) in allograft-alone rats were far in excess of corresponding values in the allograft of allograft+native kidney rats (0.88 +/- 0.1 ml/min and 1.1 +/- 0.5 g, respectively). Proteinuria (35 +/- 2 mg/d) and allograft glomerulosclerosis (24 +/- 8%) also characterized allograft-alone but not allograft+native kidney rats, in whom glomerular structure (allograft glomerulosclerosis, 4 +/- 1%; native kidney glomerulosclerosis, 0%) and glomerular functional integrity (proteinuria 7 +/- 0.7 mg/d) were well preserved. Thus, the observed allograft protection derived from the presence of a retained recipient native kidney supports the hypothesis that a single renal allograft contains insufficient nephrons to prevent progressive renal injury, implicating nephron supply as a major determinant of long-term allograft outcome.
PYELOTOMY FOR THE REMOVAL OF RENAL CALCULI
Authors: DANIEL N. EISENDRATH
Journal: JAMA (1913)

muscle.The cellular infiltration was similar to that in other locations, small mononuclear cells predominating.Abscesses of the peritoneum and especially in the mesentery were of common occurrence after intraperitoncal inoculation.In general, the lesions may be described as granulomatous.There is usually a central area of necrosis, sur¬ rounded by a zone of dense cellular infiltration, the pre¬ ponderating cells being polymorphonuclear in type.About this zone is an extensive area showing congestion, hemorrhage, infiltration of large cells with eccentric vesicular nuclei and homogeneous eosinophilic cytoplasm.There is also in til trat ion of large numbers of small mono- nuclear cells and eosinophils.Marked proliferation of connective tissue is shown in this region, and giant cells are of frequent occurrence.The spores of the organism are demonstrated in nearly every case by the mod i lied Gram stain described above.The spores prove to be distributed throughout the lesions, but are usually most numerous and most easily found at the periphery of the necrotic area..They are usually intercellular.The mycelium could not be conclusively demonstrated in paraffin sections. SUMMARYThe following observations made in connection with the present study may be briefly formulated again, as follows:1.The spores of the organism were attached to the mycelia by short pedicles.2. So-called ehlamydospores were of frequent occur¬ rence.3. Spores, similar in form to those grown on blood- serum, could usually he demonstrated in paraffin sec¬ tions of the tissue lesions, and shown in most cases in direct preparations from the abscesses.4. In one case it appeared that mycelial growth took place in the necrotic tissue at the center of a large abscess caused by the organism.5. Methyl thionin proved best for staining the organ¬ ism grown on artificial médiums, and a modification of Gram's stain most satisfactory for its demonstration in the tissues.(i.The organism failed to liquefy gelatin after six weeks' growth at room temperature. 7. Milk was coagulated after two weeks' growth al.room temperature. 8. Some hint of the possibility of producing an immunity in animals by previous injection of small doses of pure culture may perhaps be based on these observations.There is however insufficient basis for any definite statement.