tbuckley/cabot-search huggingface dataset:
Disappearing teaspoons: Teaspoons may reappear
Authors: Katherine Darton
Journal: BMJ (2006)

Good quality monitoring is crucial for informed choiceEditor-In accordance with the patient choice scheme, all 303 primary care trusts in England were obliged from January 2005 to offer patients a choice of at least two providers for cataract surgery. 1 The scheme allows patients to be involved in how, where, and when they are treated.Providers can be NHS trusts, diagnostic and treatment centres, or independent sector providers from the UK or overseas.By February 2005 13 000 extra operations had already been performed under the independent sector treatment programme. 2However, concern was raised about variations in clinical safety between different providers. 3 We sent a postal questionnaire to the leaders of patient choice for each of the primary care trusts in England asking how they monitor the quality of care from their providers.The table shows the replies from 125 trusts.The quality monitoring of providers by primary care trusts is poorly structured and variable.Who then should monitor standards and what variables should they use?Traditionally, NHS providers have used audit and clinical governance to measure their performance.Should it now be the role of the Strategic Health Authority, the provider, or the purchaser in the form of primary care trusts to monitor the product offered to the patient?Information technology exists to collect accurate data about adverse events in addition to visual acuity and refractive outcomes.The public expect that safe cataract care should be commissioned for them, 4 and robust methods of monitoring need to be agreed and implemented so that patients can make a truly informed choice.These decisions need to be made not only for cataract surgery but also for other elective procedures that will increasingly be made available to patients through the patient choice scheme.
Developed countries should not impose ethics on other countries
Authors: T. Richards
Journal: BMJ (2002)

Ethical codes drawn up predominantly by experts from developed countries should not be imposed on the rest of the world, an African epidemiologist told a conference of European medical ethicists last week.

“Dogmatic interpretation of universal ethical principles in medical research will paralyse research efforts to improve HIV/AIDS prevention and treatment in sub-Saharan Africa,” Dr Nicolas Meda, an epidemiologist from Burkina Faso, warned the meeting in Brussels.

Health research in poor countries should be designed and conducted pragmatically, taking into account local health needs and priorities, he said.

The meeting was organised by the European Group on Medical Ethics, a body appointed by the European Commission to advise it on ethical aspects of …
Poems and quotations
Authors: T. Dalrymple
Journal: BMJ (2011)

Dr Johnson famously defined a lexicographer as a harmless drudge, a maker of dictionaries; his own dictionary contained 100 000 quotations from English authors, illustrating the early use of words from written examples. This was perhaps a feat of erudition unequalled in the history of philology, but there have been many learned anthologists who deserve our admiration, even if mere compilation is not the highest form of literary art.

Among them is Henry G Bohn, one of the giants of 19th century publishing and bookselling. He invented cheap and commercial editions of the classics. Emerson said of him that he had done for books what railways had done for travel. But he also compiled a Dictionary of Poetical Quotations , with …
Fiona Patterson replies to Parashkev Nachev
Authors: Fiona Patterson
Journal: BMJ (2007)

“Although there is over a century's literature on selection methodologies, rarely has any process provoked such fierce debate as MTAS. Many facts surrounding specialty selection, and our role within it, are not well understood. This is illustrated by Dr Nachev's personal view ( BMJ 2007;335:615 doi: 10.1136/bmj.39342.515961.59), which contains two fundamental factual inaccuracies. The problems surrounding selection methodology are multi-faceted and multi-dimensional, well beyond disregarding CVs, relying on ‘white space' questions and poor IT delivery.” 

For the distress caused, I share the anger of the profession. The inquiry led by Sir John Tooke details the facts about our role in the process (www.mmcinquiry.org.uk). Here, I highlight critical issues to encourage close scrutiny of facts surrounding principles, methodology, and context underlying MTAS, so that there is learning for the future.

Clearly, in the past, selection practices in medicine have been effective. Although few would deny there is scope for improvement, the CV and interview process has generally worked well. So why change? MTAS was devised alongside the MMC (Modernising Medical Careers) programme introduced by the Department of Health, where the fundamental principles underpinning gateways to progression were changed overnight. Consequently this changed the rules governing selection. Traditionally, medicine has relied on robust indicators of attainment on the CV, such …
Early progression of thymocytes along the CD4/CD8 developmental pathway is regulated by a subset of thymic epithelial cells expressing transforming growth factor beta.
Authors: Y Takahama, J J Letterio, H Suzuki, A G Farr, A Singer
Journal: The Journal of Experimental Medicine (1994)

Precursor cells differentiate into mature CD4+ and CD8+ T cells in the inductive environment of the thymus by undergoing a series of distinct developmental steps marked by expression of the coreceptor molecules CD4 and CD8. Among the earliest cells to enter the CD4/CD8 developmental pathway are CD4-CD8lo precursors cells that differentiate into CD4+CD8+ thymocytes. Here we show that differentiation of precursor cells into CD4+CD8+ thymocytes requires at least one cell division and that their progression through a cell cycle is specifically retarded in the thymus by interaction with thymic epithelial cells that express transforming growth factor beta (TGF-beta) proteins. We also demonstrate that TGF-beta proteins, either in solution or bound to cell membranes, can regulate cell cycle progression and differentiation of CD4-CD8lo precursor cells into CD4+CD8+ thymocytes. The regulatory effect of TGF-beta is specific for CD4-CD8lo precursor cells as TGF-beta proteins do not regulate the earlier generation of CD4-CD8lo precursor cells from CD4-CD8- thymocytes. Finally, we demonstrate that TGF-beta proteins are expressed in vivo in the intact thymus on subcapsular and cortical thymic epithelium where they can contact developing CD4-CD8lo precursor cells. Thus, thymic epithelial cells expressing TGF-beta proteins can actively regulate the rate at which CD4+CD8+ thymocytes are generated from CD4-CD8lo precursor cells.
There is no such thing as aging
Authors: R. Peto, R. Doll
Journal: BMJ (1997)

Taking all diseases together (but ignoring deaths from accidents or violence), the total death rate in developed countries such as Britain is 500 times greater at age 80 than at age 20. For vascular disease, chronic respiratory disease, and cancers of the digestive or respiratory tract, this ratio is more than 1000 to 1. Why? What biological mechanisms account for this vast difference in mortality between old and young adults? And, since so many major diseases are much more common in old than in young adults, does this imply that there must be some common biological process called “aging” that causes all of these large differences in mortality? Our answer, particularly for cancer, is that it need not do so.1

What the major diseases of adult life have shared for tens of millions of years is a common set of evolutionary pressures tending to relegate them to old age, but such relegation is likely to involve many different mechanisms. Natural selection acts much more strongly against death in early adult life than against death in old age. Hence, other things being equal, all major adult diseases will tend to be much commoner in old age than in early adult life.

Before asking whether “aging itself” has any direct effects on the development of disease, it may be useful to consider whether there is any fundamental biological process that can usefully be labelled aging. If so, what is it? Is it …
522 Combination therapy with peginterferon alfa-2A (40KD) (PEGASYS®) plus ribavirin (COPEGUS®) in treatment-naive patients with chronic hepatitis C and genotype 1 infection: Individual estimated probability of sustained virological response (SVR)
Authors: O. Weiland, M.W. Fried, S.J. Hadziyannis, G.R. Foster, D. Messinger, K. Freivogel, M. Chaneac
Journal: Journal of Hepatology (2004)
FGF-2 controls the differentiation of resident cardiac precursors into functional cardiomyocytes
Authors: Nathalie Rosenblatt-Velin, Mario G. Lepore, Cristina Cartoni, Friedrich Beermann, Thierry Pedrazzini
Journal: Journal of Clinical Investigation (2005)

Recent evidence suggests that the heart possesses a greater regeneration capacity than previously thought. In the present study, we isolated undifferentiated precursors from the cardiac nonmyocyte cell population of neonatal hearts, expanded them in culture, and induced them to differentiate into functional cardiomyocytes. These cardiac precursors appear to express stem cell antigen-1 and demonstrate characteristics of multipotent precursors of mesodermal origin. Following infusion into normal recipients, these cells home to the heart and participate in physiological and pathophysiological cardiac remodeling. Cardiogenic differentiation in vitro and in vivo depends on FGF-2. Interestingly, this factor does not control the number of precursors but regulates the differentiation process. These findings suggest that, besides its angiogenic actions, FGF-2 could be used in vivo to facilitate the mobilization and differentiation of resident cardiac precursors in the treatment of cardiac diseases.
The relationship between hepatic low-density lipoprotein receptor activity and serum cholesterol level in the human fetus
Authors: Hai-Jiang Cai, Chong-Lun Xie, Qi Chen, Xiu-Ying Chen, Yue-Hua Chen
Journal: Hepatology (1991)

We found that the binding of 125I-low-density lipoprotein to fetal liver low-density lipoprotein receptor rose progressively with the increase in fetal age. During this period, total cholesterol and low-density lipoprotein-cholesterol levels in fetal serum declined significantly. The correlation coefficients between fetal age and concentration of serum total cholesterol and low-density lipoprotein cholesterol were -0.80 (p less than 0.001) and -0.77 (p less than 0.001), respectively. A significant inverse correlation also existed between the liver low-density lipoprotein receptor activity and the serum total cholesterol (r = -0.96, p less than 0.001) and low-density lipoprotein cholesterol (r = -0.95, p less than 0.001) but not high-density lipoprotein cholesterol. It is suggested that the low-density lipoprotein receptors in human fetal liver may play a key role in the regulation of the serum cholesterol levels during gestation.
Induction of pluripotency in bone marrow mononuclear cells via polyketal nanoparticle-mediated delivery of mature microRNAs
Authors: Young-Doug Sohn, Inthirai Somasuntharam, Pao-Lin Che, Rishim Jayswal, Niren Murthy, Michael E. Davis, Young-sup Yoon
Journal: Biomaterials (2013)
GETTING TO THE HEART OF CARDIAC REMODELLING: HOW COLLAGEN SUBTYPES MAY CONTRIBUTE TO PHENOTYPE
Authors: Patrick Collier, Chris J. Watson, Maarten H. van Es, Dermot Phelan, Osama Sharif, Elton Rexhepaj, Michael Tolan, Mark T. Ledwidge, Kenneth M. McDonald, John A. Baugh
Journal: Journal of the American College of Cardiology (2011)
Sulphasalazine induced hepatitis in juvenile rheumatoid arthritis.
Authors: D Caspi, D Fuchs, M Yaron
Journal: Annals of the Rheumatic Diseases (1992)

Two 19 year old patients with juvenile chronic arthritis developed liver toxicity during treatment with sulphasalazine. A significant increase in the levels of liver enzymes in serum samples was noticed in relation to the initiation of treatment in one patient and to the increase in dose in the second. The enzymes returned to normal levels 14 days after the drug had been stopped. A rechallenge in one of the patients caused re-exacerbation. This is the first report of liver toxicity induced by sulphasalazine in juvenile chronic arthritis. As spontaneous liver involvement in juvenile chronic arthritis is not rare, the possibility of drug induced hepatitis should be recognised in these patients.
PET/CT in the Evaluation of Lymphoma in Patients With HIV-1 With Suppressed Viral Loads
Authors: Elinor Goshen, Tima Davidson, Abraham Avigdor, Tzila S. Zwas, Itzchak Levy
Journal: Clinical Nuclear Medicine (2008)

Positron emission tomography (PET) with F-18 fluorodeoxyglucose detects active lymphoid tissue during HIV-1 infection, with distinct patterns of lymphoid activation correlating to various stages of disease activity. Patients with HIV-1 are at risk for lymphoma, making the differential diagnosis between benign and malignant lymphadenopathy imperative. This study retrospectively evaluated the role of PET/computed tomography (CT) in differentiating active lymphoma from persistent generalized lymphadenopathy in patients with HIV-1.Seven patients with HIV-1 underwent PET/CT. Six, with known non-Hodgkin lymphoma underwent a total of 16 PET/CT scans; 5/16 scans were performed for initial staging, and 10/16 for evaluating treatment response and follow-up. One patient was referred for evaluation of lymphadenopathy suspected of being lymphoma. PET/CT findings were compared with concurrent clinical, immunologic, and virological data.PET/CT accurately depicted the extent of lymphoma in 12/16 patients' scans (75%), yet in 4/16 (25%) scans increased fluorodeoxyglucose uptake was noted in lymph nodes of normal CT appearance (PET+/CT-). Viral loads ranged from 0 to 84,000 copies/mL, CD4 T-cell count ranged from 130 to 474 cells/muL in the group. The highest values of both laboratory parameters were concurrent with the discrepant PET+/CT- scans, seen in 4 scans, in 2 patients. The PET+/CT- findings in both these patients were observed in neck, axillae, mediastinum, spleen, and inguinal regions, and sample biopsies of the PET (+) nodes consequently proved benign findings in both patients. All PET+/CT+ findings correctly indicated lymphoma status, as proven by clinical follow-up.PET/CT accurately detected lymphoma in patients with HIV-1 and had been used confidently as a management tool in this patient group. In the context of discrepant PET/CT findings, increased viral loads and CD4 levels may imply benign HIV-related lymphadenopathy.
Authorship! Authorship!-Reply
Authors: Drummond Rennie
Journal: JAMA (1994)

<h3>In Reply</h3> —We thank Drs Green and Kasper for their comments. Green writes that we tended to skirt the problems presented when promotion is awarded on the basis of number rather than quality of publications and when honorary authorship may be awarded in return for favors. In fact, we thought we addressed these problems directly, noting, in the title and elsewhere, that publications are the coins used to assess academic worth and bemoaning the lack of standards to assess the value of the coinage and the impossibility of judging anyone's merit by counting the number of their papers. We also cited a few of the many articles that have been written on this subject, some of them making the same points as those made by Green, for example, listing the authors' relative contributions. As we suggested, the academic tenure and promotion committee is, for the academic, where the rubber meets
Improved method for diagnosis of polycythemia vera based on flow cytometric analysis of autonomous growth of erythroid precursors in liquid culture
Authors: Daphna Manor, Eliezer A. Rachmilewitz, Eitan Fibach
Journal: American Journal of Hematology (1997)

"Autonomous" development of erythroid colonies in erythropoietin (EPO)-free semi-solid culture has been used as an in vitro assay for diagnosis of polycythemia vera (PV). These colonies, however, are small and poorly hemoglobinized, rendering the assay in many cases unreliable. We report here on the use of a novel assay; it combines a modified culture procedure that maximizes the growth of EPO-independent erythroid cells, and immunofluorescence flow cytometry for their detection and quantitation. Peripheral blood mononuclear cells are cultured for 2-5 days in the presence of a combination of growth factors. During this phase, early erythroid committed progenitors, burst forming units (BFUe), proliferate and differentiate into colony forming units (CFUe)-like progenitors. In the second phase, the latter cells, in the presence of stem cell factor, hemin, and iron-saturated transferrin, continue to proliferate and mature into hemoglobin (Hb)-containing orthochromatic normoblasts. Neither phases contained EPO. The culture produced large, pure, and synchronized erythroid cell populations. The cells were then dually labeled with fluorescent probes, nuclear DNA with thiazole orange and intracellular hemoglobin (Hb) with phycoerythrin-conjugated monoclonal antibodies against human Hb. Cells positive for both labels were assigned as Hb-containing nucleated precursors. The presence of such cells in EPO-free cultures indicated "autonomous growth." None of the EPO-free cultures derived from normal donors or patients with secondary polycythemia contained such cells. Cultures derived from PV patients contained from 5 to 92% "autonomously grown" cells. These culture and analysis methods should minimize false negative results with PV patients and provide objective and quantitative data.
Technetium stannous pyrophosphate myocardial scintigrams in patients with chest pain of varying etiology.
Authors: J T Willerson, R W Parkey, F J Bonte, S L Meyer, J M Atkins, E M Stokley
Journal: Circulation (1975)

Technetium-99m stannous pyrophosphate was utilized for myocardial imaging in 202 patients admitted to the hospital with chest pain of uncertain etiology. One hundred and one patients had clinical and evolved electrocardiographic and enzymatic evidence of acute myocardial infarction. Ninety-six of these 101 patients had increased myocardial uptake of the technetium stannous pyrophosphate and positive myocardial scintigrams; there was nearly precise correlation between the ECG and myocardial imaging localization of the area of infarction for acute transmural myocardial infarctions. In the five patients with negative myocardial images the scintigrams were obtained after seven or more days had elapsed following the myocardial infarction. In the remaining 101 patients no clinical, ECG, or enzymatic evidence of infarction developed; 92 of these patients had negative myocardial scintigrams. Seven of the remaining nine patients were admitted with "unstable angina pectoris", and despite the absence of diagnostic ECG and enzyme evolution each of these patients had faintly and diffusely positive myocardial scintigrams. The remaining two patients had positive myocardial scintigrams but no definite ECG or enzymatic evidence of acute myocardial infarction. Thus the technetium pyrophosphate imaging technique appears safe, inexpensive and to correlate well with ECG and enzyme identification of the presence of infarction and with ECG localization of myocardial infarction. In addition the positive myocardial scintigrams in some patients with "unstable angina" suggest that there may be limited myocardial necrosis that is ordinarily undetected by ECG and enzymes in these patients. The incidence of false positive and false negative scintigrams appears to be small.
Hip Fractures and Fluoridation in Utah's Elderly Population
Authors: Christa Danielson
Journal: JAMA (1992)

To test the effect of water fluoridated to 1 ppm on the incidence of hip fractures in the elderly.Ecological cohort.The incidence of femoral neck fractures in patients 65 years of age or older was compared in three communities in Utah, one with and two without water fluoridated to 1 ppm.All patients with hip fractures who were 65 years of age and older over a 7-year period in the three communities, excluding (1) those with revisions of hip fractures, (2) those in whom the hip fracture was anything but a first diagnosis, (3) those in whom metastatic disease was present, or (4) those in whom the fracture was a second fracture (n = 246).Rate of hospital discharge for hip fracture.The relative risk for hip fracture for women in the fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to 1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to the nonfluoridated areas.We found a small but significant increase in the risk of hip fracture in both men and women exposed to artificial fluoridation at 1 ppm, suggesting that low levels of fluoride may increase the risk of hip fracture in the elderly.
PCBs, PCQs and PCDFs in tissues of yusho and yu-cheng patients.
Authors: H Miyata, S Fukushima, T Kashimoto, N Kunita
Journal: Environmental Health Perspectives (1985)

All five samples of oil involved in the recent yu-cheng outbreak were heavily contaminated with PCBs, PCQs and PCDFs at levels, on the average, of 62, 20 and 0.14 ppm, respectively. The samples not only had roughly one-tenth of the contamination by PCBs, PCQs and PCDFs but also three to four times lower ratios of PCQs and PCDFs to PCBs than samples of oil involved in yusho in Japan. PCBs, PCQs and PCDFs present were all composed of similar congeners to the ones found in the yusho specimens, though some variation of the component ratios of PCBs and PCDFs were observed. On the other hand, five patients with yusho who died 1 to 10 years following poisoning had markedly higher tissue levels of PCDFs and PCQs than did a worker occupationally exposed to PCBs. Taking great differences in the process of the healing and the tissue levels of PCBs, PCQs and PCDFs between the two poisoning cases into consideration, PCDFs and PCQs--especially the former--and not PCBs are deduced to be strongly associated with the development of yusho.
Group R streptococcal infection.
Authors: M R Clements, D V Hamilton
Journal: BMJ (1981)

East.-9 Fifthly, far from having no side effects as stated by Dr Haworth, mepacrine in doses of 100 mg/day is well known to cause in a proportion of persons mental disturbances, aplastic anaemia, and derma- toses.I " Finally, not one but six of the seven signatories have recent experience of practising medicine in the tropics.This brings us to the substance of our recommendations.In areas of chloroquine resistance our first recommendation would be Fansidar, but there is need for an alternative during pregnancy and for those sensitive to sulphonamides.In our view the risks from malaria are greater than the risks from twice-weekly Maloprim.Nevertheless, it is only fair to state that whereas our recommendations were made in conformity with those of a committee at the London School of Hygiene and Tropical Medicine, that committee decided at a subsequent meeting on 14 January to err on the side of caution and to recommend a once-weekly dose of Maloprim for those who need to take it.The subject needs further study.However, on the basis of our own and other people's experience we believe that the recommendations were the best available in the light of current knowledge.