tbuckley/cabot-search huggingface dataset:
Letter: Dextran 70 and thromboembolism.
Authors: M Marshall
Journal: BMJ (1975)

cause of cardiovascular disease, which ac- counts for about half the excess mortality from smoking.You state that there is little substan(tial decline in either cigarette sales or the num- ber of people who smoke, yet you do not point out ithe dramatic fall of cigarette smok- ing in doctors, in other menbers of social class 1, and in class 2, especially among men.You refer to the impossible goal of stopping smolking by healith education programmes, yet after the first of the two recent Thames Television progranxnes, "Dying for a Fag," it was estimated that about 160 000 people stopped smoking at least temporarily, and this represents about 2% of the smoking population.The fact that the tobacco in- dustry is putting some of their workers on short time illustrates that the fall in 'tobacco sales whieh followed the recent itax increase is -expected to last.It would ihave been more appropriate if, instead of decrying health education you had followed -the B.M.A.Council's Tecommendation' in relation to smoking that "more attention should be paid to the way in which information is dis- seminated and attitudes are formed and an evaluation made of the methods used."It is conceivable that in 20 years theire may Tbe evidence to s.how that cigarettes whieh include synthetic material,s are in- deed safer.Until this time arrives we strongly deplore the use of the tern "safer cigarettes," though we agree tlhat efforts to investigate forms of smoking which may be less lefthal should be encouraged.Doctors should give patients the same advice to stop smoking which they them- selives have accepted and which has been such an importan cause of the reduction in mortality from both lung cancer and coronary heart disease in ¢he medical pro- fession.-Weare, etc.,
Intracranial pressure monitoring in severe traumatic brain injury
Authors: P. J. Hutchinson, A. G. Kolias, M. Czosnyka, P. J. Kirkpatrick, J. D. Pickard, D. K. Menon
Journal: BMJ (2013)

Should not be abandoned on the basis of recent evidence 

In a trial recently published in the New England Journal of Medicine , Chesnut and colleagues attempted to provide class I evidence on the impact of intracranial pressure (ICP) monitoring on functional and neuropsychological outcomes after traumatic brain injury (TBI).1 The authors concluded that there was no difference in the primary outcome—a composite of 21 equally weighted components—between the group of patients who had ICP monitoring and the group that did not. This is a landmark study; undertaking such a trial has long been considered impossible because most experts considered ICP monitoring the primary basis for managing patients with severe TBI.2 However, the findings require some scrutiny before we can consider a fundamental change in our approach to managing these patients.

Since it was introduced into clinical practice more than 50 years ago, ICP monitoring has gradually become the standard of care in most centres that treat patients with severe TBI in the United Kingdom, North America, and most developed countries.2 The physiological basis of ICP monitoring in TBI is twofold. Firstly, increasing ICP indicates escalating mass effect (from haematomas, contusions, or diffuse brain swelling). If escalating mass effect is left untreated, brain herniation and death will follow. Secondly, ICP has a direct impact on cerebral perfusion pressure (the mean arterial blood pressure minus ICP). It …
Cimetidine for peptic ulcer in patients with arthritis.
Authors: J R Croker, P B Cotton, A C Boyle, P Kinsella
Journal: Annals of the Rheumatic Diseases (1980)

Patients taking anti-inflammatory drugs for arthritis are prone to dyspepsia, and management of peptic ulcer is difficult because surgery is poorly tolerated. In this open study cimetidine treatment was associated with ulcer healing in 17 out of 21 patients with arthritis even when anti-inflammatory treatment was continued. Remission was maintained for 1 year by continued cimetidine therapy.
CDC: Ebola Risk to US Patients Is Low, But Clinicians Should Be on Alert
Authors: Joan Stephenson
Journal: JAMA (2014)

Oneworry is that risingheroinusemay be a sign that individuals are shifting from prescription opioid abuse to other opioid drugs. From 2010 to 2012, Florida saw a 24%decreaseinoxycodoneprescribingbut a37%increaseinmorphineprescribing.The state also saw an increase in heroin overdose deaths during the same period, from 48 to 108 (0.3 to0.6 per 100 000people in the state). Johnsonsaid this increase, althoughconcerning, is small comparedwith the simultaneous reductions in prescriptionoverdoses,whichdecreasedfrom2722 in 2010 to 2116 in 2012. This reduced the prescription overdose rate to 11 per 100 000, the lowest in the state since 2007, according to the report on Florida’s efforts. Paulozzi said economic factors and greater availability of heroin may be drivingsomeopioiduserstoheroin,ashasbeen reported in some surveys. But there aren’t cleardataexplainingwhyheroinusehas increased in thenortheasternUnitedStates. For now, the CDC is focusing on preventing prescription opioid abuse. “We are interested in upstream interventions,” said Paulozzi. “We want to get ahead of the problem before people become dependent and prevent them from turning toheroinbecauseof its lowerprice and high availability.”
Allergy to Latex Rubber
Authors: Gordon L. Sussman
Journal: Annals of Internal Medicine (1995)

Objective: To summarize the clinical symptoms of latex rubber allergy and provide guidelines for the management of this allergy. Data Sources: The English-language literature was searched from 1979 through 1994 manually and using MEDLINE. Conference proceedings and reference lists of relevant articles were reviewed. Data Extraction: Studies clinically relevant to latex allergy were selected. Results: The most common clinical presentation of latex allergy is a nonimmunologic, irritant dermatitis of the hand. Contact dermatitis (type IV delayed hypersensitivity reactions to rubber additives) is the most common immunologic manifestation of latex rubber allergy. Type I allergic responses are less common and include contact urticaria, rhinoconjunctivitis, asthma, and anaphylaxis. Seven percent to 10% of health care workers regularly exposed to latex and 28% to 67% of children with spina bifida have a positive skin test result to latex proteins indicating increased blood levels of IgE antibody. About one third of patients with positive skin test results, however, do not yet have symptoms of latex allergy. Systemic (life-threatening) anaphylactic shock can occur intraoperatively in highly sensitive patients because of mucosal absorption of latex protein allergens from the surgeon's gloves. The present treatment for latex allergy is careful avoidance of latex materials. In addition, the use of powder-free latex gloves can eliminate airborne latex exposure and can allow health care workers with inhalant allergic reactions to return to work. Conclusion: Latex allergy currently affects thousands of people. These persons have IgE-mediated cutaneous, respiratory, and systemic allergic reactions. A reduction of the total protein level on latex rubber devices may prevent further sensitization and eliminate latex allergic reactions.
Protein arginine methylation in hepatic glucose metabolism regulation: Histone or nonhistone? That is the question
Authors: Zhenyu Xu, Yue Wang, Houqi Liu
Journal: Hepatology (2012)

In a recent report, Choi et al.1 demonstrated that protein arginine methyltransferase-1 (PRMT1)-dependent arginine modification of FoxO1 contributed to the regulation of hepatic glucose production in a mouse model. However, despite presenting the finding of the FoxO1 protein, the investigators failed to discuss another well-defined class of PRMT1 substrates: histones, methylations of which have been identified as key "histone codes" in epigenetic regulation2 and have been shown to regulate hepatic gluconeogenesis under the control of another PRMT in a previous study by Krones-Herzig et al.3 Herein, we compare the two similar studies and suggest that PRMT1-mediated histone arginine methylation should be involved in the network of hepatic glucose metabolism regulation. Both groups found that the PRMTs regulated the same target genes, but methylated different proteins (Table 1). Herzig et al. suggested that PRMT4 contributed to the regulation of hepatic glucose metabolism by methylating histone H3, because methylations of H3 arginines are known to be transcriptional activation markers.4 Based on these findings, we hypothesize that the function of PRMT1 in the regulation of hepatic glucose production may also be mediated by the methylation of histones, because PRMT1 is known to methylate histone H4 at arginine 3, generating the H4R3me2a marker, thus contributing to the histone codes as a transcriptional activation marker, similarly to PRMT4.5 Furthermore, as transcriptional coactivators, both PRMT1 and PRMT4 are often recruited to promoters by a number of different transcription factors.2 Because PRMT4 has been reported to enhance nuclear factor kappa light-chain enhancer of activated B cells–mediated gene transcription by methylation of histone H3,6 it is reasonable to presume that PRMT1 also enhances FoxO1-mediated gene transcription through the methylation of histone H4, which may be another unrevealed mechanism of hepatic glucose production regulation. Further studies on PRMT1-mediated histone methylation may advance our understanding of the role of histone codes in hepatic gene regulation. Thus, the current findings of Choi et al. are expected to have profound significance. Zhenyu Xu*, Yue Wang*, Houqi Liu*, * Research Center of Developmental Biology, Second Military Medical University, Shanghai, China.
Abstract 4437: Fbxw8 targets hematopoietic progenitor kinase 1 for proteasomal degradation
Authors: Hua Wang, Yue Chen, Ping Lin, Lei Li, Guisheng Zhou, Guangchao Liu, Craig Logsdon, Jianping Jin, James L. Abbruzzese, Tse-Hua Tan, Huamin Wang
Journal: Cancer Research (2014)

Abstract HPK1, a member of mammalian Ste20-like serine/threonine kinases, is lost in &amp;gt;95% pancreatic cancer through proteasomemediated degradation. However, the mechanism of HPK1 loss has not been defined. The aims of this study are to identify the ubiquitin ligase and to examine the mechanisms that targets HPK1 degradation. We found that the CUL7 ubiquitin ligase targeted HPK1 for degradation via the 26S proteasome. The ubiquitination of HPK1 required its kinase activity and autophosphorylation. Wild-type protein phosphatase 4 (PP4), but not the phosphatase-dead PP4 mutant, PP4-RL, inhibits the interaction of Fbxw8 with HPK1 and Fbxw8-mediated ubiquitination of HPK1. In addition, we showed that Thr355 of HPK1 is a key PP4 dephosphorylation site, through which Fbxw8 and PP4 regulates HPK1 stability. Our study demonstrated that CUL7 ubiquitin ligase targets HPK1 for degradation which requires HPK1 kinase activity and autophosphorylation. Fbxw8-mediated HPK1 degradation revealed a direct link and novel role of CUL7 ubiquitin ligase in the MAPK pathway, which plays a critical role in cell proliferation and differentiation. Citation Format: Hua Wang, Yue Chen, Ping Lin, Lei Li, Guisheng Zhou, Guangchao Liu, Craig Logsdon, Jianping Jin, James L. Abbruzzese, Tse-Hua Tan, Huamin Wang. Fbxw8 targets hematopoietic progenitor kinase 1 for proteasomal degradation. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4437. doi:10.1158/1538-7445.AM2014-4437
British Qualifications Abroad
Authors: I. M. Griffith
Journal: BMJ (1958)

<h3>Introduction</h3> Oral antimicrobials, including ciprofloxacin, levofloxacin and doxycycline, are susceptible to binding with enteral therapies such as calcium and iron therapies. Administered together, the bioavailability of these antimicrobials is expected to be reduced. <h3>Methods</h3> A retrospective case series of patients receiving oral antimicrobials (ciprofloxacin, levofloxacin and doxycycline) was analysed at a single-centre NHS acute hospital (April 2016–September 2019). Patient demographics, including concurrent enteral therapies, were recorded using medical records. Clinically important interactions were defined as doses administered within 2 hours of antimicrobial therapy. <h3>Results</h3> A total of 4067 prescriptions for the study antimicrobials (ciprofloxacin, n=1905; levofloxacin, n=538; and doxycycline, n=1624) were prescribed for 3584 patients. 1918/3583 (53.5%) of the patients were female, and the median age was 67 years (range 0.5–105.0 years). 810/4067 (19.3%) prescriptions reviewed had an interacting enteral therapy (calcium or iron salt) administered within 2 hours of the study medication. <h3>Conclusion</h3> The concomitant administration of enteral calcium and iron with oral antimicrobials is common within the acute care hospital setting. Approximately one in five patients has a clinically important interaction which may impair oral bioavailability and limit treatment efficacy. As antimicrobial stewardship teams strive for increased intravenous-to-oral de-escalation, it is important that optimum dosing administration is followed to optimise patient outcomes.
Points from letters: Rheumatic heart disease in South Africa
Authors: J G K Dean
Journal: BMJ (1975)

NHS family planning services SIR,-In the BM7 (19 July, p 185) it is re- ported that "the profession's negotiators [our italics] and the DHSS have agreed a scheme for the provision of family planning services through the hospital service, for all FP work, whether of medical or social origin."We are astonished that there has been, as yet, minimal medical or public reaction to this retrograde proposal.It is the feeling of the undersigned staff of the obstetrical and gynaecological department in Aberdeen that this scheme is indisputably bad.The reasons for its introduction are far from obvious and the advantages in terms of patient care are difficult to define.Furthermore, it may turm out to have a dangerously disruptive effect among different grades of staff in many gynaecological and anaesthetic departments, including theatre staff and porters.It seems ludicrous for a health service short of money in a time of rapid inflation to put out extra money to its highest paid workers.This is all apart from the questionable morality of the scheme and the inevitable difficulties it will present in the counselling of patients who seek unbiased family planning advice.
Efficiency, equity, and NICE clinical guidelines
Authors: Allan Wailoo, Jennifer Roberts, John Brazier, Chris McCabe
Journal: BMJ (2004)

Clinical guidelines need a broader view than just the clinical 

The stated purpose of clinical guidelines from the United Kingdom's National Institute for Clinical Excellence (NICE) is to “help healthcare professionals and patients make the right decisions about healthcare in specific clinical circumstances.”1 However, what constitutes “the right decisions” depends on your point of view. For individual patients the right decision is that which maximises their wellbeing, and this is properly the concern of the clinician. Yet in resource constrained healthcare systems this will not always coincide with the right decisions for patients in general or society as a whole, thereby leading to some understandable tensions. NICE is a national policy making body whose responsibility is clearly broader than the individual patient.2 This wider viewpoint is reflected in NICE's technology appraisals by the central role afforded to cost effectiveness. We argue that the methods currently used by the NICE clinical guideline programme confuse these two viewpoints.

Cost effectiveness analysis allows decision makers to improve efficiency by …
Research Priorities in Hereditary Hemochromatosis
Authors: Gary M. Brittenham
Journal: Annals of Internal Medicine (1998)

The Working Group on Research Priorities used a formal nominal group technique to identify and prioritize the specific aims of applied research needed to provide the scientific basis for population screening for iron overload disorders. The most important applied research goal was characterization of the natural history of the relation between genotype and phenotype in hereditary hemochromatosis and other iron overload disorders. Three other important research objectives were development of an optimal approach to screening for iron overload; analyses of the cost-effectiveness of screening; and assessment of the ethical, legal, and social implications of screening. To achieve these specific aims, two research studies were recommended as being of the highest priority: a multicenter, cross-sectional, population-based study of the natural history of iron overload and a multicenter, case-control study of patients with disease manifestations potentially attributable to hereditary hemochromatosis in primary care and subspecialty clinics.
Noninvasive automated assessment of the ratio of pulmonary to systemic flow in atrial septal defects by spatio-temporal integration of Doppler velocity profile
Authors: T. Hozumi, K. Yoshida, Y. Ueda, T. Akasaka, T. Takagi, S. Kaji, T. Kawamoto, S. Morioka
Journal: Journal of the American College of Cardiology (1998)
US drug companies announce vaccine initiative
Authors: J. Ciment
Journal: BMJ (2000)

Responding to an appeal from President Clinton, the heads of the world's four largest vaccine manufacturers announced a plan to donate $150m (£94m) worth of “state of the art” vaccines to the developing world after a meeting at the White House on 2 March.

The four companies—Merck and Company, American Home Products, SmithKline Beecham, and Aventis Pharmaceuticals—also pledged to increase their budgets for research and development for HIV/AIDS and malaria vaccines.

The donations will be channelled largely through the Global Alliance for Vaccines and Immunization, an international group of business leaders (including Bill Gates of Microsoft, philanthropic organisations, development banks, agencies …
MICRO DOSE DISTRIBUTION IN THE THYROID FOLLICLE, A REVISED METHOD BASED ON AN ANATOMICAL DISTRIBUTION OF RADIOIODINE IN THE FOLLICLE LUMEN
Authors: M. X. Jia, V. J. Ficken, E. W. Allen, J. R. Prince
Journal: Clinical Nuclear Medicine (1992)

S: APRIL 9–12, 1992 San Antonio Convention Center & Hyatt Regency Hotel SAN ANTONIO, TEXAS Southwestern Chapter Society of Nuclear Medicine SPECT/PET Nuclear Cardiology Symposium and 37th Annual Meeting: PDF Only
Primary Care in Transition
Authors: Philip R. Alper
Journal: JAMA (1994)

It is generally agreed that too few physicians have chosen careers in primary care. The advent of managed care as a popular method of health care provision is now affecting primary care physicians in ways that may further discourage enthusiasm for the practice of primary care and have an unintended negative effect on the primary care physician supply. In addition, the early implementation of the resource-based relative value scale by Medicare and some insurance carriers has been less beneficial to primary care physicians than expected and may even have been harmful to general internists. Efforts to improve the position of primary care physicians in relation to payers and among peers are hindered by the fact that, as a group, primary care physicians are less affluent, less influential, and greatly outnumbered by their more specialized colleagues. Consequently, some of the support currently directed toward primary care may be more apparent than real. My proposals, which aim both to protect and to enhance primary care practice, are the creation of separate primary care fee schedules and separate primary care budgets within health plans, changes in consumer protection rules that intrude on primary care practice, and the development of statewide primary care associations for mutual support and greater bargaining power. Some aspects of contracting and gatekeeping require further study.
TCT-678 Comparison of Invasive and Non-invasive Data of the Ratio between the Effective and Geometric Aortic Valve Area in Normal and Low Flow Patients: Overestimation of aortic stenosis severity by Doppler with Low Flow: A TAVR Study
Authors: Amr Abbas, Marc Sakwa, Francis Shannon, Kerolos Shenouda, Abhay N. Bilolikar, Ivan D. Hanson, Robert Safian, George Hanzel, Frances Wood
Journal: Journal of the American College of Cardiology (2014)
The area ratio of normal arterial junctions and its implications in pulse wave reflections
Authors: G. L Papageorgiou, B. N Jones, V. J Redding, N. Hudson
Journal: Cardiovascular Research (1990)

The aim of the study was to establish measurements for the area ratios of normal arterial junctions at various anatomical sites in order to estimate the significance of pulse wave reflections in the healthy arterial system.Coronary cineangiograms were used for the coronary junctions measurements and routine arteriograms for the rest of the junctions studied. A pair of digital calipers served to take measurements at a distance of one vessel diameter from the junction centre.A bell shaped distribution of arterial area ratios was found with mean value for coronary bifurcations of 1.179 (95% confidence limits, 1.138-1.220). Slightly higher values were found for the higher order coronary junctions. Other junctions had similar area ratio values with the exception of the aortoiliac junctions where the area ratio was found 0.848 (0.775-0.920). Overall area ratio was 1.14 (1.113-1.167). Asymmetrical coronary bifurcations had higher area ratio than symmetrical ones (p less than 0.05).In the majority of cases the area ratios are in close agreement with the theoretically predicted values for forward matched junctions. Minimal pulse wave reflections are therefore expected to arise from the junctions of a healthy arterial system. We therefore consider that, contrary to the established view, the presence of reflected waves in the central arterial system is a potential pathological phenomenon and not a characteristic of the healthy system. This may have important theoretical implications for the way hemodynamic findings are interpreted. Finally we suggest that arterial area ratio can be considered as another criterion of normality of arterial junctions in the interpretation of angiograms.
Hospital Admissions for Hypoglycemia Now Exceed Those for Hyperglycemia in Medicare Beneficiaries
Authors: Rita F. Redberg
Journal: JAMA Internal Medicine (2014)

Kasia J. Lipska, MD, MHS; Joseph S. Ross, MD; Yun Wang, PhD; Silvio E. Inzucchi, MD; Karl Minges, MPH; Andrew J. Karter, PhD; Elbert S. Huang, MD; Mayur M. Desai, PhD, MPH; Thomas M. Gill, MD; Harlan M. Krumholz, MD, SM
Assessing Competencies of Knowledge and Process Improvement—Reply
Authors: Eric S. Holmboe
Journal: JAMA (2008)

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