tbuckley/cabot-search huggingface dataset:
Leading healthcare in London: time for a radical response?
Authors: N. Fulop, R. Raine
Journal: BMJ (2013)

King’s Fund report should have been even more radical 

London’s health services have not been short of reviews, blueprints, and plans over the past 20 years.1 2 The latest, published by the King’s Fund,3 describes the current healthcare landscape across London within the context of the new NHS and the progress made in implementing Lord Darzi’s recommendations in his 2007 report, Framework for Action .2 Developments in London since 2011 are outlined in this new report. Most notable is the step change in outcomes for patients with stroke, after the major reorganisation of stroke services.4 The attempts to integrate services across whole systems are also described, but it is too early to assess their effect.5 However, we do know that London compares poorly with the rest of England with respect to its hospitals’ progress towards foundation trust status, proposed service reorganisations continue to falter in the face of sustained public opposition, and Lord Darzi’s vision to deal with the variation in quality of primary care has gained little momentum. In sum, the NHS in London is already in a “difficult situation” at a time when it is also …
Interference by Clq in Slide Latex Tests for Rheumatoid Factor
Authors: CHU-TSAI CHENG
Journal: Annals of Internal Medicine (1971)

The specificity of slide latex tests for detection of rheumatoid factor (RF) can be increased by heat-inactivating the serum (56 C, 30 minutes). Latex agglutination was decreased after heating in 187 of 372 serums studied. With few exceptions, the serums containing the heat-labile agglutinator were from patients with diseases other than rheumatoid arthritis. Forty-eight percent of serums from patients with rheumatic diseases other than rheumatoid arthritis had 1+ or greater positive latex agglutination in the unheated state, but only 9% of these were positive after heating. Serum from patients with osteoarthritis, septic arthritis, systemic lupus erythematosus, acute rheumatic fever, dermatomyositis, and Reiter's syndrome, positive before heating, became negative after incubation, increasing the specificity of the slide latex technique. The thermolabile agglutinator in serum, found to affect each of the five different slide test reagents studied, reacted in the same manner as the Clq component of complement.
Oxidative stress is enhanced in correlation with renal dysfunction: Examination with the redox state of albumin
Authors: Hiroyuki Terawaki, Kazunobu Yoshimura, Toshio Hasegawa, Yukie Matsuyama, Tsuneo Negawa, Kenichi Yamada, Masato Matsushima, Masaaki Nakayama, Tatsuo Hosoya, Seiichi Era
Journal: Kidney International (2004)
Dysfunction of the continent ileostomy: clinical features and bacteriology.
Authors: D G Kelly, S F Phillips, K A Kelly, W M Weinstein, M J Gilchrist
Journal: Gut (1983)

The pathogenesis and treatment of dysfunction of the continent ileostomy was investigated in 12 patients, five of whom had asymptomatic malabsorption and seven of whom had acute complaints. The number of anaerobic bacteria in jejunal aspirates was increased in patients with pouch malfunction (range 10(3) to 10(8)/g aspirate), but the microbiology of ileal effluent and the morphology of the ileal mucosa could not be correlated with dysfunction. Bile acid breath tests and lactose tolerance tests were not, however, reliable indicators of jejunal bacterial overgrowth. The symptoms, the malabsorption, and the number of jejunal and ileal anaerobic bacteria decreased in patients during treatment with metronidazole, implicating overgrowth of anaerobic bacterial flora in the pathogenesis of the syndrome.
IMPROVED LIMB PERFUSION AND NEOVASCULOGENESIS MEDIATED BY INTRAMUSCULAR INFUSION OF LIN-/SCA1+ PROGENITOR CELLS
Authors: Georgia Vogiatzi, Dimitris Tousoulis, Alexandros Briasoulis, Aggeliki Valatsou, Polyxeni Nikolopoulou, Konstantinos Papaxoinis, Alkistis Pantopoulou, Nikolaos Papageorgiou, Pavlos Stougiannos, Despoina Perrea
Journal: Journal of the American College of Cardiology (2011)
DNAzyme for TGF-β suppressed extracellular matrix accumulation in experimental glomerulonephritis
Authors: Yoshitaka Isaka, hiroyuki Nakamura, Masayuki Mizui, Yoshitsugu Takabatake, Masaru Horio, Hiroshi Kawachi, Fujio Shimizu, Enyu Imai, Masatsugu Hori
Journal: Kidney International (2004)
The Role of Intraluminal Sodium in Glucose Absorption In Vivo
Authors: David A. Saltzman, Floyd C. Rector, John S. Fordtran
Journal: Journal of Clinical Investigation (1972)

Active glucose absorption is thought to depend on a gradient of sodium ion concentration across the brush border membrane of intestinal epithelial cells. This concept is generally accepted, although its validity has never been adequately evaluated in the human small intestine in vivo. According to this hypothesis, the rate of glucose absorption should decrease markedly if the luminal sodium concentration is markedly reduced, and glucose absorption against a concentration gradient should cease entirely if luminal sodium is lower than intracellular sodium concentration. In the present series of experiments we were not able to show an important role of intraluminal sodium concentration in the active absorption of glucose from the human, rat, and dog ileum in vivo. Specifically, glucose absorption was minimally reduced or not reduced at all when intraluminal sodium concentration was reduced from 140 to as low as 2.5 mEq/liter. The discrepancy between our results and those of previous workers whose data suggest that removal of intraluminal sodium should markedly inhibit active glucose absorption is not entirely clear, but there are a number of differences in experimental design between most previous studies and our own. Although our data show that active glucose absorption proceeds at a near normal rate even when lumen sodium concentration is reduced below 3 mEq/liter, our results do not disprove the sodium gradient theory because of the theoretic possibility that the microclimate adjacent to the brush border has a high concentration of sodium even when luminal sodium concentration is markedly reduced. The validity of the sodium gradient hypothesis would appear to be critically dependent on such a microclimate.
Representativeness of the Surveillance, Epidemiology, and End Results Program Data: Recent Trends in Cancer Mortality Rates
Authors: C. M. Frey, M. M. McMillen, C. D. Cowan, J. W. Horm, L. G. Kessler
Journal: JNCI Journal of the National Cancer Institute (1992)

Mortality, incidence, and survival rates are the primary measures used by the National Cancer Institute (NCI) to monitor cancer in the United States. The Surveillance, Epidemiology, and End Results (SEER) data system collects data on all cancers diagnosed among residents in geographically defined populations, which comprise about 10% of the U.S. population. This data system is the major component of the NCI system for tracking these rates. Thus, it is important to assess the degree to which SEER data are representative of the entire U.S. population.National data on mortality, but not on incidence or survival, are available from the National Center for Health Statistics. These data provide a census against which mortality data from the subset of the SEER regions may be compared.Multivariate regression analyses of age-adjusted mortality rates from 1975 to 1988, computed for the SEER areas and for the entire United States, were performed for race- and sex-specific data from 15 cancer sites. Representativeness was evaluated by testing for differences in trends and levels between the data from the U.S. population and those from the SEER Program.Data from the SEER regions reflected the correct direction of trend for all sites, although some race-, sex-, and site-specific differences existed for the magnitude of the trends and levels of mortality when compared with data from the U.S. population.The demonstration that data from the SEER population do occasionally yield mortality rates that differ from those for the entire U.S. population suggests that data from the SEER coverage population are, in some cases, not representative of the greater U.S. population.This issue is of particular relevance to the interpretation of incidence measures, computed from the SEER data, for which there is no national database. Future efforts should be directed at a better understanding of how the SEER population differs from the U.S. population so that SEER rates can be adjusted to be more nationally representative.
Let's not screen women under 25 throughout the UK
Authors: C. O'Mahony, N. Steedman, M. Yong, E. R Anderson, V. Finnegan, L. Price
Journal: BMJ (2009)

For many years doctors working in English sexual health services have been frustrated that the policy on age of first cervical smear test is not consistent throughout the United Kingdom, although published papers show the futility of cervical screening under the age of 25.1 The recent editorial and paper by Sasieni and colleagues categorically state that cervical …
Peanut Oral Immunotherapy (OIT) Induces Immunologic Changes Supporting the Development of Tolerance
Authors: P. Varshney, S.M. Jones, L. Pons, M. Kulis, P.H. Steele, A.R. Kemper, A.M. Scurlock, T.T. Perry, A.W. Burks
Journal: Journal of Allergy and Clinical Immunology (2010)
Changes of Natriuretic Peptides Predict Hospital Admissions in Patients With Chronic Heart Failure
Authors: Gianluigi Savarese, Francesca Musella, Carmen D’Amore, Enrico Vassallo, Teresa Losco, Francesco Gambardella, Milena Cecere, Laura Petraglia, Gennaro Pagano, Luigi Fimiani, Giuseppe Rengo, Dario Leosco, Bruno Trimarco, Pasquale Perrone-Filardi
Journal: JACC Heart Failure (2014)
Projectitis? Supporting health reform
Authors: Peter D Toon
Journal: BMJ (2005)

<h3>Objective</h3> Pancreatic cysts are commonly detected in patients undergoing pancreatic imaging. Better approaches are needed to characterise these lesions. In this study we evaluated the utility of detecting mutant DNA in secretin-stimulated pancreatic juice. <h3>Design</h3> Secretin-stimulated pancreatic juice was collected from the duodenum of 291 subjects enrolled in Cancer of the Pancreas Screening trials at five US academic medical centres. The study population included subjects with a familial predisposition to pancreatic cancer who underwent pancreatic screening, and disease controls with normal pancreata, chronic pancreatitis, sporadic intraductal papillary mucinous neoplasm (IPMN) or other neoplasms. Somatic <i>GNAS</i> mutations (reported prevalence ∼66% of IPMNs) were measured using digital high-resolution melt-curve analysis and pyrosequencing. <h3>Results</h3> <i>GNAS</i> mutations were detected in secretin-stimulated pancreatic juice samples of 50 of 78 familial and sporadic cases of IPMN(s) (64.1%), 15 of 33 (45.5%) with only diminutive cysts (&lt;5 mm), but none of 57 disease controls. <i>GNAS</i> mutations were also detected in five of 123 screened subjects without a pancreatic cyst. Among 97 subjects who had serial pancreatic evaluations, <i>GNAS</i> mutations detected in baseline juice samples predicted subsequent emergence or increasing size of pancreatic cysts. <h3>Conclusion</h3> Duodenal collections of secretin-stimulated pancreatic juice from patients with IPMNs have a similar prevalence of mutant <i>GNAS</i> to primary IPMNs, indicating that these samples are an excellent source of mutant DNA from the pancreas. The detection of <i>GNAS</i> mutations before an IPMN is visible suggests that analysis of pancreatic juice has the potential to help in the risk stratification and surveillance of patients undergoing pancreatic screening.
Sex Chromatin Frequency
Authors: Lois I. Platt, Eloise W. Kailin
Journal: JAMA (1964)

In our review of routine vaginal smears on 100 well patients, we found that sex chromatin frequency averaged 55.8%. On 40 additional well clinic patients special vaginal preparations showed similar average count (55.5%). No special staining technique was necessary to visualize sex chromatin. Reproducible counts were possible only if each observer adhered closely to specific criteria in counting. In six robustly healthy laboratory workers, counts were high (average 71.5%). In psychosis, atopy, and chemical reaction syndrome counts were substantially diminished (averages: 35.8%, 38.5%, and 11.5%). In the latter syndrome counts rose four- or fivefold (from 11.5% to 45.9%, averages) in the spring and a connection between this increase and the discontinuation of home heating was suspected. Reversible intranuclear edema or intranuclear migration of the chromatin body in response to stress situations was postulated as a possible cause of the lowering of sex chromatin counts in disease states.
Successful treatment of steroid and cyclophosphamide‐resistant hemolysis in chronic lymphocytic leukemia with rituximab
Authors: Jens Chemnitz, Andreas Draube, Volker Diehl, Jürgen Wolf
Journal: American Journal of Hematology (2002)

To the Editor: Chronic lymphocytic leukemia was diagnosed in a 63year-old female patient in May 1991.Peripheral blood smears showed increased leucocytes (18,500/ll) with up to 90% lymphocytes positive for CD 19 (97%) and CD 5 (52%).Bone marrow involvement was 80%.Initial CT scans showed multiple lymphomas at different regions enlarged up to 2 cm.Thrombocytes were slightly decreased to 127,000/ll and hemoglobin was normal with 14.3 g/dl.Treatment with chlorambucil (6 mg/m 2 p.o.; days 1À3) and prednisone (75 mg/day p.o. day 1, 50 mg/day p.o. day 2, 25 mg/day p.o. day 3) repeated every 2 weeks was initiated between December 1993 and September 1994 and between June 1996 and April 1997.In October 1998 the patient developed progressive disease with 88% lymphocytes in the peripheral blood smears, 90% bone marrow in®ltration, multiple abdominal lymphomas enlarged up to 4 cm, progressive splenomegaly and, in addition autoimmune hemolytic anemia (AIHA).Repeated treatment with chlorambucil and prednisone yielded no response.In February 1999 irradiation of the spleen (8 Gy) was initiated because of massive splenic enlargement (30 cm).During radiation therapy a dramatic aggravation of hemolysis developed.Laboratory data were: leucocytes 6,500/ll, platelets 57,000/ll, hemoglobin 5.7 g/dl, bilirubin 6.0 mg/dl, indirect bilirubin 4.9 mg/dl, haptoglobin <0.05 g/l, lactate dehydrogenase (LDH) 378 U/l.The direct Coombs test was strongly positive.Steroid dosage was increased to 40 mg dexamethasone per day for 4 days followed by 50 mg prednisone/ day.This high-dose steroid treatment initially resulted in a slight improvement of hemoglobin, but reduction of the steroid medication led to renewed aggravation of hemolysis.Also three cycles of chemotherapy with cyclophosphamide (750 mg/m 2 i.v.every 4 weeks) did
Learning to swim with the Griffiths tide.
Authors: G J Smith, D H Makinson, S C Farrow
Journal: BMJ (1986)

For some time-and more so since the Griffiths inquiry'-the range and volume of management training opportunities for doctors have increased.In most regions in the United Kingdom optional courses are offered yet many doctors are appointed as consultants without any management education and training.The need for more formal management training has been advocated by Parkhouse2 and more recently the Association for the Study of Medical Education has endorsed the idea of developing systematic training.3What is required is a programme that regards management training not as an option but as an integral
Toxicologic and epidemiologic clues from the characterization of the 1952 London smog fine particulate matter in archival autopsy lung tissues.
Authors: Andrew Hunt, Jerrold L Abraham, Bret Judson, Colin L Berry
Journal: Environmental Health Perspectives (2003)

Exposure to atmospheric fine particulate matter (PM), even at low ambient concentrations, has clearly been linked to increases in mortality and morbidity. A 10- micro g m(-3) increase in PM10 (PM < 10 micro m) has been found to produce a 0.5% increase in daily mortality. The mechanism of action is a source of debate, although recent attention has focused on the cardiac effects of PM exposures. Likewise, several possible etiologic agents have been implicated, including ultrafine PM (PM <or= 100 nm), metals, and the acid components, yet the responsible constituent remains undetermined. During the catastrophic PM exposure episode in London in December 1952, some 4,000 excess deaths occurred at the height of the event. The extreme mortality during that episode and the preservation of archival autopsy tissues allow us the unique opportunity to report on the form and composition of December 1952 London PM in situ in tissues from persons known to have died from the smog exposure. Because absolute increases in mortality with current levels of PM in Western Europe and North America are low, analogous tissues are unlikely to be contemporaneously available. Taking a lung compartment (airway, airspace, interstitium, and lymph node) approach, we differentiated exposures contemporary with death from those of earlier origin. Electron microscopic analyses revealed the dominance of retained soot and a surfeit of other particle types. A variety of metal-bearing particle types were found in all compartments, but Pb, Zn, and SnZn types appeared the least biopersistent. The results support the acute toxicologic importance of ultrafine carbonaceous and metal PM.
Bowen's Disease and Internal Cancer
Authors: Irwin M. Braverman
Journal: JAMA (1991)

In 1959 and 1961, Graham and Helwig<sup>1,2</sup>reported an unexpected association: Bowen's disease of the skin (epidermoid carcinoma in situ) was followed, after a variable latent period of 1.3 to 13 years, by the eventual development of internal cancer in 48% of affected individuals. The cancers involved all three germ layers and included lymphomas and leukemias. Multiple reports by others supporting these observations followed immediately,<sup>3-5</sup>and the concept that Bowen's disease was a high-risk factor for the future development of cancer, especially if it occurred on a part of the body not exposed to the sun, became an established fact in textbooks. In the past decade, however, these findings have not been confirmed,<sup>6-8</sup>and the validity of the observation has been questioned because of errors in the methods of data acquisition.<sup>6,9,10</sup>The earlier studies have been criticized because of lack of appropriate
Glycocalyx-mimetic dextran-modified poly(vinyl amine) surfactant coating reduces platelet adhesion on medical-grade polycarbonate surface
Authors: A. Sen Gupta, S. Wang, E. Link, E.H. Anderson, C. Hofmann, J. Lewandowski, K. Kottke-Marchant, R.E. Marchant
Journal: Biomaterials (2006)
FEEDING IN DYSPHAGIC CONDITIONS: AN EFFICIENT METHOD
Authors: Howard Lilienthal
Journal: JAMA (1928)

The problem of feeding patients who are too ill to take nourishment normally may be the pivotal factor in the success or failure of treatment.  Rectal feeding at best is unsatisfactory, and in many instances it cannot be employed because the enema is at once expelled.  The Einhorn duodenal tube, once in position in the stomach or duodenum, will of course make the administration of liquids a simple matter. The tube, as has been demonstrated in gastric disease, may be kept in place indefinitely and with very little annoyance to the patient.  When the function of deglutition is so impaired that the tube cannot be swallowed, or when the patient is stuporous or comatose, I employ a simple method for insertion of the tube, and the result has been so gratifying that I feel obliged to pass the idea on to the profession.  A long ureteral catheter is threaded
Five English hospital trusts have higher than expected deaths, finds new mortality measure
Authors: N. Hawkes
Journal: BMJ (2013)

The EP<sub>2</sub> and EP<sub>4</sub> prostanoid receptor subtypes are G-protein-coupled receptors for prostaglandin E<sub>2</sub> (PGE<sub>2</sub>). Both receptor subtypes are known to couple to the stimulatory guanine nucleotide binding protein (Gα<sub>s</sub>) and, after stimulation with PGE<sub>2</sub>, can increase the formation of intracellular cAMP. In addition, PGE<sub>2</sub> stimulation of the EP<sub>4</sub> receptor can activate phosphatidylinositol 3-kinase (PI3K) leading to phosphorylation of the extracellular signal-regulated kinases (ERKs) and induction of early growth response factor-1 (EGR-1) (<i>J Biol Chem</i><b>278</b>: 12151–12156, 2003). We now report that the PGE<sub>2</sub>-mediated phosphorylation of the ERKs and induction of EGR-1 can be blocked by pretreatment of EP<sub>4</sub>-expressing cells with pertussis toxin (PTX). Furthermore, pretreatment with PTX increased the amount of PGE<sub>2</sub>-stimulated intracellular cAMP formation in EP<sub>4</sub>-expressing cells but not in EP<sub>2</sub>-expressing cells. These data indicate that the EP<sub>4</sub> prostanoid receptor subtype, but not the EP<sub>2</sub>, couples to a PTX-sensitive inhibitory G-protein (Gα<sub>i</sub>) that can inhibit cAMP-dependent signaling and activate PI3K/ERK-dependent signaling.
Massachusetts Medical Society
Authors: David D. Scannell
Journal: New England Journal of Medicine (1947)

A STATED meeting of the Council of the Massachusetts Medical Society was called to order by the president, Dr. Dwight O'Hara, on February 5, 1947, at 10:30 a.m. in John Ware Hall, 8 Fenway, Boston, Massachusetts. Two hundred and one councilors were present (Appendix No. 1).The President announced that the secretary, Dr. Michael A. Tighe, was absent because of illness. He expressed a wish for his speedy recovery. The President announced that for the purpose of the meeting he appointed Dr. Robert N. Nye as acting secretary. This appointment was confirmed by the vote of the Council. The Acting . . .
Acute erythroid leukemia (AEL) can be separated into distinct prognostic subsets based on cytogenetic and molecular genetic characteristics
Authors: V Grossmann, U Bacher, C Haferlach, S Schnittger, F Pötzinger, S Weissmann, A Roller, C Eder, A Fasan, M Zenger, M Staller, W Kern, A Kohlmann, T Haferlach
Journal: Leukemia (2013)
Long QT syndrome, Brugada syndrome, and conduction system disease are linked to a single sodium channel mutation
Authors: Augustus O. Grant, Michael P. Carboni, Valentina Neplioueva, C. Frank Starmer, Mirella Memmi, Carlo Napolitano, Silvia Priori
Journal: Journal of Clinical Investigation (2002)

The function of the 12 positive charges in the 53-residue III/IV interdomain linker of the cardiac Na+ channel is unclear. We have identified a four-generation family, including 17 gene carriers with long QT syndrome, Brugada syndrome, and conduction system disease with deletion of lysine 1500 (ΔK1500) within the linker. Three family members died suddenly. We have examined the functional consequences of this mutation by measuring whole-cell and single-channel currents in 293-EBNA cells expressing the wild-type and ΔK1500 mutant channel. The mutation shifted V1/2h∞ to more negative membrane potentials and increased kh consistent with a reduction of inactivation valence of 1. The shift in h∞ was the result of an increase in closed-state inactivation rate (11-fold at –100 mV). V1/2m was shifted to more positive potentials, and km was doubled in the ΔK1500 mutant. To determine whether the positive charge deletion was the basis for the gating changes, we performed the mutations K1500Q and K1500E (change in charge, –1 and –2, respectively). For both mutations, V1/2h was shifted back toward control; however, V1/2m shifted progressively to more positive potentials. The late component of Na+ current was increased in the ΔK1500 mutant channel. These changes can account for the complex phenotype in this kindred and point to an important role of the III/IV linker in channel activation.