tbuckley/cabot-search huggingface dataset:
Why are patients with acute stroke admitted to hospital?
Authors: J Bamford, P Sandercock, C Warlow, M Gray
Journal: BMJ (1986)

Data on 515 consecutive patients registered with the Oxfordshire Community Stroke Project were used to compare the characteristics of those patients who were admitted to hospital within one month after their first stroke with those who remained in the community during that time. Twenty eight patients had their stroke while in hospital for other conditions, and of the remaining 487, 266 were admitted. Though patients with a severe neurological deficit were significantly more likely to be admitted, 47 out of 202 such patients were managed in the community. In a substudy of 162 consecutive patients the general practitioners9 reasons for either arranging admission to hospital or continuing with community care in the first week after the stroke were ascertained. Sixty patients were admitted. The only reason for admission was diagnostic uncertainty in five cases (though this was a contributing factor in 25) and to provide nursing or general, non-medical care in 25. Patients who lived alone were more likely to be admitted. All 12 patients who presented directly to the casualty department were admitted, though only five had had a severe stroke. A stroke service that provides a facility for rapid outpatient and domiciliary diagnosis as well as a rapidly acting domiciliary nursing team might reduce the number of patients with stroke admitted to hospital without adversely affecting the quality of patient care: this should be properly evaluated.
Researchers find genetic basis for susceptibility to mycobacteria
Authors: D. Josefson
Journal: BMJ (1999)

Spain's Ministry of Health has launched a major initiative to encourage health professionals to stop smoking.The programme started earlier this month.It will be carried out in collaboration with the National Committee for Smoking Prevention and is directed at all doctors and nurses working at the 82 public hospitals and 1115 primary care centres directly managed by the Spanish
A great time to invest in baby Boomer's hepatitis C!
Authors: Marie-Louise Vachon, Douglas T. Dieterich
Journal: Hepatology (2012)

BACKGROUND: In the United States, hepatitis C virus (HCV) infection is most prevalent among adults born from 1945 through 1965, and approximately 50% to 75% of infected adults are unaware of their infection. OBJECTIVE: To estimate the cost-effectiveness of birth-cohort screening. DESIGN: Cost-effectiveness simulation. DATA SOURCES: National Health and Nutrition Examination Survey, U.S. Census, Medicare reimbursement schedule, and published sources.TARGET POPULATION: Adults born from 1945 through 1965 with 1 or more visits to a primary care provider annually.TIME HORIZON: Lifetime.PERSPECTIVE: Societal, health care.INTERVENTION: One-time antibody test of 1945-1965 birth cohort.OUTCOME MEASURES: Numbers of cases that were identified and treated and that achieved a sustained viral response; liver disease and death from HCV; medical and productivity costs; quality-adjusted life-years (QALYs); incremental cost-effectiveness ratio (ICER). RESULTS OF BASE-CASE ANALYSIS: Compared with the status quo, birth-cohort screening identified 808,580 additional cases of chronic HCV infection at a screening cost of $2874 per case identified. Assuming that birth-cohort screening was followed by pegylated interferon and ribavirin (PEG-IFN+R) for treated patients, screening increased QALYs by 348,800 and costs by $5.5 billion, for an ICER of $15,700 per QALY gained. Assuming that birth-cohort screening was followed by direct-acting antiviral plus PEG-IFN+R treatment for treated patients, screening increased QALYs by 532,200 and costs by $19.0 billion, for an ICER of $35,700 per QALY saved. RESULTS OF SENSITIVITY ANALYSIS: The ICER of birth-cohort screening was most sensitive to sustained viral response of antiviral therapy, the cost of therapy, the discount rate, and the QALY losses assigned to disease states. LIMITATION: Empirical data on screening and direct-acting antiviral treatment in real-world clinical settings are scarce. CONCLUSION: Birth-cohort screening for HCV in primary care settings was cost-effective. PRIMARY FUNDING SOURCE: Division of Viral Hepatitis, Centers for Disease Control and Prevention.
Rapid chromosome territory relocation by nuclear motor activity in response to serum removal in primary human fibroblasts
Authors: Ishita S Mehta, Manelle Amira, Amanda J Harvey, Joanna M Bridger
Journal: Genome biology (2010)

Radial chromosome positioning in interphase nuclei is nonrandom and can alter according to developmental, differentiation, proliferation, or disease status. However, it is not yet clear when and how chromosome repositioning is elicited.By investigating the positioning of all human chromosomes in primary fibroblasts that have left the proliferative cell cycle, we have demonstrated that in cells made quiescent by reversible growth arrest, chromosome positioning is altered considerably. We found that with the removal of serum from the culture medium, chromosome repositioning took less than 15 minutes, required energy and was inhibited by drugs affecting the polymerization of myosin and actin. We also observed that when cells became quiescent, the nuclear distribution of nuclear myosin 1 beta was dramatically different from that in proliferating cells. If we suppressed the expression of nuclear myosin 1 beta by using RNA-interference procedures, the movement of chromosomes after 15 minutes in low serum was inhibited. When high serum was restored to the serum-starved cultures, chromosome repositioning was evident only after 24 to 36 hours, and this coincided with a return to a proliferating distribution of nuclear myosin 1 beta.These findings demonstrate that genome organization in interphase nuclei is altered considerably when cells leave the proliferative cell cycle and that repositioning of chromosomes relies on efficient functioning of an active nuclear motor complex that contains nuclear myosin 1 beta.
Bridging the equity gap in maternal and child health
Authors: Zulfiqar A Bhutta
Journal: BMJ (2005)

Bridging the equity gap in maternal and child health Will depend on health systems research as well as actionWe cannot allow it to be said by history that the difference between those who lived and died . . .was nothing more than poverty, age, or skin colour.John Lewis, Congressman from Georgia, on the devastation caused by hurricane Katrina. 1
Topiramate in the Treatment of Binge Eating Disorder Associated With Obesity: A Randomized, Placebo-Controlled Trial
Authors: Susan L. McElroy, Lesley M. Arnold, Nathan A. Shapira, Paul E. Keck, Norman R. Rosenthal, M. Rezaul Karim, Marc Kamin, James I. Hudson
Journal: American Journal of Psychiatry (2003)

Binge eating disorder is associated with obesity. Topiramate is an antiepileptic agent associated with weight loss. The objective of this study was to evaluate topiramate in the treatment of binge eating disorder associated with obesity.For this 14-week, double-blind, flexible-dose (25-600 mg/day) topiramate trial, 61 outpatients (53 women, eight men) with binge eating disorder who were obese (body mass index >/=30 kg/m(2)) were randomly assigned to receive topiramate (N=30) or placebo (N=31). The primary efficacy measure was binge frequency. The primary analysis of efficacy was a repeated-measures random regression with treatment-by-time as the effect measure.Compared with placebo, topiramate was associated with a significantly greater rate of reduction in binge frequency, binge day frequency, body mass index, weight, and scores on the Clinical Global Impression severity scale and the Yale-Brown Obsessive Compulsive Scale (modified for binge eating). Topiramate was also associated with significantly greater reductions in binge frequency (topiramate: 94%, placebo: 46%) and binge day frequency (topiramate: 93%, placebo: 46%) and with a significantly higher level of response than placebo. The mean weight loss for topiramate-treated subjects who completed the study was 5.9 kg. Median topiramate dose was 212 mg/day (range=50-600). Nine patients (three receiving placebo, six given topiramate) discontinued because of adverse events. The most common reasons for discontinuing topiramate were headache (N=3) and paresthesias (N=2).Topiramate was efficacious and relatively well tolerated in the short-term treatment of binge eating disorder associated with obesity.
Identification of prognostic factors predicting outcome in Hodgkin's lymphoma patients relapsing after autologous stem cell transplantation
Authors: C. Martínez, C. Canals, B. Sarina, E.P. Alessandrino, D. Karakasis, A. Pulsoni, S. Sica, M. Trneny, J.A. Snowden, E. Kanfer, N. Milpied, A. Bosi, S. Guidi, C.A. de Souza, R. Willemze, R. Arranz, L. Jebavy, A. Hellmann, D. Sibon, R. Oneto, J.J. Luan, P. Dreger, L. Castagna, A. Sureda
Journal: Annals of Oncology (2013)
1039 ALPHAFETOPROTEIN AND TRANSPLANT SURVIVAL BENEFIT FOR PATIENTS WITH HEPATOCELLULAR CARCINOMA: A MULTICENTRE COHORT STUDY
Authors: A. Vitale, R. Ramirez Morales, G. Zanus, F. Farinati, P. Burra, P. Angeli, A.C. Frigo, P. Del Poggi, G. Rapaccini, M.A. Di Nolfo, L. Benvegnü, M. Zoli, F. Borzio, E.G. Giannini, E. Caturelli, M. Chiaramonte, F. Trevisani, U. Cillo
Journal: Journal of Hepatology (2012)
Alcohol and heart disease Drinking advice inconsistent and unscientific
Authors: G Winstanley
Journal: BMJ (1994)

EDITOR, - John Kemm claims that advice about drinking to individual members of the public has been fairly consistent over the past decade.1 This is surprising.

In 1979 a special committee of the Royal College of Psychiatrists stated that the absolute upper weekly limit was about 56 units of alcohol.2 In 1981, however, the Department of Health and Social Security stated that these weekly limits were in fact quite high but declined to give precise …
Reversal of periodic breathing after aerobic training in heart failure
Authors: R. R. T. Castro, L. M. Antunes-Correa, L. M. Ueno, M. U. P. B. Rondon, C. E. Negrão, A. C. L. Nóbrega
Journal: European Respiratory Journal (2010)

To the Editors: 

A 58-yr-old male was referred for participation in a cardiac rehabilitation programme. He had a long-term history of hypertensive cardiomyopathy and systolic dysfunction and was clinically stable, being treated with β-blocker carvedilol, losartan, digitalis, diuretics and spironolactone, with no changes in medication in the previous 16 weeks. An echocardiogram showed a 17% left ventricular ejection fraction and the patient was in New York Heart Association Functional Class III.

Before starting the exercise training programme, the patient was submitted to a maximal progressive cardiopulmonary exercise test, on an electromagnetically braked cycle ergometer (Medifit 400L; Medical Fitness Equipment, Maarn, The Netherlands), with work rate increments of 5 W every 1 min at 60 rpm until exhaustion. Oxygen uptake ( V′ O2) and carbon dioxide production were determined by means of gas exchange on a breath-by-breath basis in a computerised system (Vmax 229 model; SensorMedics, BuenaVista, CA, USA). Peak V′ O2 was defined as the maximum attained V′ O2 at the end of the exercise period in which the patient could no longer maintain the cycle rate. During this test, the patient showed a very low exercise capacity, with a peak V′ O …
Electrocardiographic Analysis by Computer
Authors: Charles E. Kossmann
Journal: JAMA (1965)

The desirability of conserving the electrocardiographer's time and energy by automation of the routine involved in the interpretation of a large daily load of electrocardiograms is self-evident. Two aspects of this load, namely the recording of the traces and final interpretation of them in terms of the total clinical picture presented by the patient, are not likely to yield in any considerable degree to handling by machine. By contrast it is in the areas of statistical analysis, codification, quantitative differential diagnosis, and speedy retrieval of information that the computer will contribute in a most profound degree to electrocardiography.  Certain old and a few new principles relative to recording must be observed perhaps even more rigorously than the former were alone. The reason is that the computer cannot recognize distortions caused by slow-deflection times, discrepancies in electrode resistances, and misplacement of lead wires. Further, if the data for differential diagnosis of
Adverse Effect on Bacteria of Peritoneal Dialysis Solutions that Contain Acetate
Authors: J. A. Richardson, K. A. Borchardt
Journal: BMJ (1969)

Peritoneal dialysis solutions which contained 43 mEq per litre of acetate had a greater antibacterial effect than those containing lactate. Bacteria were isolated from 15 separate clinical infections, each caused by Escherichia coli, Pseudomonas sp., or Staphylo-coccus aureus. Incubation in the dialysate made with acetate substantially reduced the number of viable organisms from all but one of the 45 isolates. It is suggested that solutions made with acetate may provide greater protection from peritonitis.
ABSCESS OF THE THYROID GLAND
Authors: Allen H. Moore
Journal: JAMA (1933)

Abscess of the thyroid gland is rarely primary; metastatic in character, it usually follows one of the acute infectious diseases, more commonly pneumonia, tonsillitis or cervical adenitis. In all the accounts, suppuration of the thyroid is considered rare, thyroiditis in general occurring in from 1 to 0.25 per cent in operative material and observed clinical cases. There is no age at which the disease cannot be found. According to Miggend, women are more susceptible than men. Meara and MacGregor<sup>1</sup>reported a case in a 3½ year old child with a suppurating thyroid. Wilkins<sup>2</sup>reported a case occurring at the age of 74. The usual age of incidence is from 20 to 45 years. When suppuration of the thyroid develops, the abscesses are as a rule multiple, each, however, tending to break through the adjoining soft tissues, thus leading to confluence and to rupture through the skin or purulent
Childhood cancer: overview of incidence trends and environmental carcinogens.
Authors: S H Zahm, S S Devesa
Journal: Environmental Health Perspectives (1995)

An estimated 8000 children 0 to 14 years of age are diagnosed annually with cancer in the United States. Leukemia and brain tumors are the most common childhood malignancies, accounting for 30 and 20% of newly diagnosed cases, respectively. From 1975 to 1978 to 1987 to 1990, cancer among white children increased slightly from 12.8 to 14.1/100,000. Increases are suggested for leukemia, gliomas, and, to a much lesser extent, Wilms' tumor. There are a few well-established environmental causes of childhood cancer such as radiation, chemotherapeutic agents, and diethylstilbestrol. Many other agents such as electromagnetic fields, pesticides, and some parental occupational exposures are suspected of playing roles, but the evidence is not conclusive at this time. Some childhood exposures such as secondhand cigarette smoke may contribute to cancers that develop many years after childhood. For some exposures such as radiation and pesticides data suggest that children may be more susceptible to the carcinogenic effects than similarly exposed adults.
Abstract 5260: Genomic gains in prostatic carcinoma and proliferative inflammatory atrophy in dogs
Authors: Carlos E. Fonseca Alves, Ariane F. Busso, Sara M. Silveira, Silvia R. Rogatto, Renee Laufer Amorim
Journal: Cancer Research (2012)

Abstract The dog can spontaneously develop prostate cancer and consequently can be used as an experimental model for prostatic diseases associated with aging, including benign prostate hyperplasia (BPH) and prostate carcinoma (PCa). DNA copy number variations (CNVs) have been used to identify genes associated with cancer development and progression. DNA microarray based comparative genomic hybridization (aCGH) is a technique that allows to identify copy number of thousands of genes throughout the genome. aCGH was used to identify genomic regions with significantly different DNA copy number in three benign prostatic hyperplasia (BPH), four proliferative inflammatory atrophy (PIA), and 14 canine prostate carcinoma (PCa). Five histologically normal prostate tissue were used as reference. Genomic DNA was extracted from formalin fixed and paraffin embedded samples and CNVs data was evaluated in Canine Genome CGH Microarray 4x44K (G2519F, Design ID021193, Agilent). Data analysis was performed using Genomic Workbench Standard Edition 5.0.14 (Agilent). PCa showed higher number of altered genes related to canonical diseases process, cellular functions and molecular pathways as well as greater inter-relationship between genes, compared with PIA and BPH. In conclusion, PCa showed a more complex genotype, being losses the most frequent genomic changes. Some discrepancies between genomic alterations in human and canine carcinomas may indicate the different clinical behavior of these tumors in these two species. In addition, it was observed was an ascending pattern of genomic complexity in BPH, PIA and CA consistent with a model of multistep tumor progression. 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 5260. doi:1538-7445.AM2012-5260
Effect of Communication Skills Training for Residents and Nurse Practitioners on Quality of Communication With Patients With Serious Illness
Authors: J. Randall Curtis, Anthony L. Back, Dee W. Ford, Lois Downey, Sarah E. Shannon, Ardith Z. Doorenbos, Erin K. Kross, Lynn F. Reinke, Laura C. Feemster, Barbara Edlund, Richard W. Arnold, Kim O’Connor, Ruth A. Engelberg
Journal: JAMA (2013)

Communication about end-of-life care is a core clinical skill. Simulation-based training improves skill acquisition, but effects on patient-reported outcomes are unknown.To assess the effects of a communication skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes.Randomized trial conducted with 391 internal medicine and 81 nurse practitioner trainees between 2007 and 2013 at the University of Washington and Medical University of South Carolina.Participants were randomized to an 8-session, simulation-based, communication skills intervention (N = 232) or usual education (N = 240).Primary outcome was patient-reported quality of communication (QOC; mean rating of 17 items rated from 0-10, with 0 = poor and 10 = perfect). Secondary outcomes were patient-reported quality of end-of-life care (QEOLC; mean rating of 26 items rated from 0-10) and depressive symptoms (assessed using the 8-item Personal Health Questionnaire [PHQ-8]; range, 0-24, higher scores worse) and family-reported QOC and QEOLC. Analyses were clustered by trainee.There were 1866 patient ratings (44% response) and 936 family ratings (68% response). The intervention was not associated with significant changes in QOC or QEOLC. Mean values for postintervention patient QOC and QEOLC were 6.5 (95% CI, 6.2 to 6.8) and 8.3 (95% CI, 8.1 to 8.5) respectively, compared with 6.3 (95% CI, 6.2 to 6.5) and 8.3 (95% CI, 8.1 to 8.4) for control conditions. After adjustment, comparing intervention with control, there was no significant difference in the QOC score for patients (difference, 0.4 points [95% CI, -0.1 to 0.9]; P = .15) or families (difference, 0.1 [95% CI, -0.8 to 1.0]; P = .81). There was no significant difference in QEOLC score for patients (difference, 0.3 points [95% CI, -0.3 to 0.8]; P = .34) or families (difference, 0.1 [95% CI, -0.7 to 0.8]; P = .88). The intervention was associated with significantly increased depression scores among patients of postintervention trainees (mean score, 10.0 [95% CI, 9.1 to 10.8], compared with 8.8 [95% CI, 8.4 to 9.2]) for control conditions; adjusted model showed an intervention effect of 2.2 (95% CI, 0.6 to 3.8; P = .006).Among internal medicine and nurse practitioner trainees, simulation-based communication training compared with usual education did not improve quality of communication about end-of-life care or quality of end-of-life care but was associated with a small increase in patients' depressive symptoms. These findings raise questions about skills transfer from simulation training to actual patient care and the adequacy of communication skills assessment.clinicaltrials.gov Identifier: NCT00687349.
Rules on EU doctors threaten patients' safety, says House of Lords report
Authors: C. Dyer
Journal: BMJ (2011)

European Union rules allowing doctors and other healthcare professionals free mobility within the European Union pose an “unacceptable risk” to the safety of patients, says a report from the House of Lords.

The EU’s directive on mutual recognition of professional qualifications strikes the wrong balance between allowing professionals to work in all EU countries and ensuring the safety of patients, says the social policy and consumer protection subcommittee of the House of Lords’ European Union select committee.

The issue hit the headlines in 2009 when Daniel Ubani, a locum doctor from Germany on his first stint working for an out of hours service in …
A Contribution to the Treatment of Hepatic Abscess, with Cases
Authors: N. Macleod
Journal: BMJ (1891)

urinie.Shc atteiided as ain out-patient for soeine timie, during whicli the swvelling wvas noticed to rise and fall imore tlhani once.The attack.sweie brouglht oni by aniy unluisual exertioni, anld she was seldom a foirtniglht free ]10 laOII pai n.
X‐Ray Excited Luminescence Chemical Imaging of Bacterial Growth on Surfaces Implanted in Tissue
Authors: Fenglin Wang, Yash Raval, Tzuen‐Rong J. Tzeng, Jeffrey N. Anker
Journal: Advanced Healthcare Materials (2015)

A pH sensor film is developed that can be coated on an implant surface and imaged using a combination of X-ray excitation and visible spectroscopy to monitor bacterial infection and treatment of implanted medical devices (IMDs) through tissue. X-ray scintillators in the pH sensor film generate light when an X-ray beam irradiates them. This light first passes through a layer containing pH indicator that alters the spectrum according to pH, then passes through and out of the tissue where it is detected by a spectrometer. A reference region on the film is used to account for spectral distortion from wavelength-dependent absorption and scattering in the tissue. pH images are acquired by moving the sample relative to the X-ray beam and collecting a spectrum at each location, with a spatial resolution limited by the X-ray beam width. Using this X-ray excited luminescence chemical imaging (XELCI) to map pH through ex vivo porcine tissue, a pH drop is detected during normal bacterial growth on the sensor surface, and a restoration of the pH to the bulk value during antibiotic treatment over the course of hours with milli-meter resolution. Overall, XELCI provides a novel approach to noninvasively image surface pH for studying implant infections and treatments.