tbuckley/cabot-search huggingface dataset:
Bolus Obstruction after Partial Gastrectomy
Authors: P. H. Powley
Journal: BMJ (1961)

The occurrence in six months of three cases of bolus obstruction after partial gastrectomy prompted an investigation into the subject, and it was found that in the period 1951-60 nine patients suffering from this condition were treated by the gastric unit at St. James' Hospital, no fewer than six of them in the last two years.It is realized that these cases were all admitted by a hospital in which over 300 partial gastrectomies are performed each year, and the policy of the hospital is to accept any patient who has previously been under its care; however, bolus obstruction is a common con- dition and will become increasingly common as more people have partial gastrectomies.It deserves to be well known.Brief reports of these nine cases are out- lined below.Case Reports Case 1.A woman aged 61 had had a Billroth I partial gastrectomy at St. James' Hospital eight years previously.
Operative Mortality and 5-Year Survival Rates in Men with Bronchogenic Carcinoma
Authors: WILLIAM WEISS
Journal: Annals of Internal Medicine (1969)

Twelve teaching hospitals in Philadelphia reported histologically proved cases of bronchogenic carcinoma to the County Medical Society Subcommittee on Lung Cancer from 1956 to 1965. A study was made of the first 421 men who were operated on and had 5-year follow-up. Of these, 156 had thoracotomy only, and 265 had resections. Age, tissue type, and surgical procedure were examined in relation to operative risk and 5-year survival. Patients explored whose cancers were not resected were included because such patients have a significant operative mortality rate but no benefit. The overall operative mortality rate was 11%, and 5-year survival rate was 13%. Operative risk increased with age but was essentially the same for the three tissue types and the type of surgery although it tended to be higher in patients with right pneumonectomy. Five-year survival was unrelated to age but was poor in men with undifferentiated carcinoma and better for those treated by lobectomy than for those who had pneumonectomy. Operative risk exceeded 5-year survival rate in men aged 70 and over, men with undifferentiated carcinoma, those explored but not resected, and in older men requiring right pneumonectomy. In these categories the therapeutic approach should be conservative.
THE AMERICAN COLLEGE OF CARDIOLOGY’S IC3 (IMPROVING CONTINUOUS CARDIAC CARE) PROGRAM AND HEART FAILURE PERFORMANCE MEASURES: A REPORT OF THE FIRST 14,000+ PATIENTS
Authors: Paul Chan, Donna Buchanan, Fran F. Fiocchi, Fengming Tang, Kristi Mitchell, Duane Thrutchley, William J. Oetgen, John S. Rumsfeld, John A. Spertus
Journal: Journal of the American College of Cardiology (2010)
Comment on: Smiechowski et al. The Use of Metformin and the Incidence of Lung Cancer in Patients With Type 2 Diabetes. Diabetes Care 2013;36:124–129
Authors: Shih-Wei Lai, Kuan-Fu Liao
Journal: Diabetes Care (2013)

One cohort study recently published in Diabetes Care about the association between metformin use and lung cancer risk was interesting. Smiechowski et al. (1) have reported that metformin use cannot correlate with decreased risk of lung cancer in patients with type 2 diabetes (rate ratio 0.94; 95% CI 0.76–1.17). However, …
Tougher action is needed on alcohol pricing, labelling, and advertisements, say experts
Authors: Z. Kmietowicz
Journal: BMJ (2013)

More than 70 health organisations have backed a call for tougher action to tackle the problems caused by excessive drinking in the United Kingdom, including targets to reduce the amount of alcohol that adults drink and to reduce the number of deaths from liver disease.

The strategy for action by the Alcohol Health Alliance says that the government needs to go beyond messages about “responsible” drinking and instead prioritise policies that would reduce alcohol sales, alcohol consumption, and alcohol related harm.1 Among its 30 recommendations are a 50p (€0.6; $0.8) minimum price per unit of alcohol sold, graphic warning labels on bottles, and a ban on alcohol sponsorship and advertising.

Scotland introduced legislation in May 2012 for a 50p …
Role of endogenous secretin in acid-induced inhibition of human gastric function.
Authors: J H Kleibeuker, V E Eysselein, V E Maxwell, J H Walsh
Journal: Journal of Clinical Investigation (1984)

The role of secretin in the inhibition of gastric acid secretion that occurs during acidification of the gastric lumen was studied in nine healthy men. Gastric acid secretion was stimulated by 500-ml meals of 8% peptone solution, and the pH of the stomach was maintained at 5.5, 2.5, or 2.0 by intragastric titration. The increase in plasma secretin was measured, after extraction, by a new secretin radioimmunoassay. After determining the intravenous dose of secretin required to reproduce plasma secretin concentrations achieved during pH 2.5 and 2.0 meals, similar doses were given during administration of a pH 5.5 peptone meal. The doses of secretin led to plasma secretin concentrations that averaged 3.4 pM, not different from the 3.2 and 3.9 pM concentrations achieved during acidified meals. However, exogenous secretin infusion failed to inhibit acid secretion or gastrin response to peptone, although significant inhibitions occurred in both during peptone meals given at pH 2.5 or 2.0. When secretin infusions were given at fivefold higher rates, plasma gastrin responses again failed to demonstrate significant inhibition. Gastric emptying was inhibited significantly by both acidified peptone meals but only slightly (P = 0.053) during exogenous infusion of physiologic secretin doses. The decrease in acid secretion could be explained by decreased gastrin release, but neither of these findings could be explained by circulating secretin concentrations. These results cast strong doubt on a physiological role of secretin in inhibition of acid secretion in man.
NHS is not ready for a 48 hour working week
Authors: R. MacDonald
Journal: BMJ (2002)

Health minister John Hutton admitted last week that the government did not have a strategy in place to deal with the introduction of the European working time directive, due to be incorporated into UK law by 2004.

The government is particularly worried about a recent ruling from the European Court of Justice, which included in the definition of “work” any time that a doctor is at his or her employer's disposal, including time that he or she is asleep, but resident in the hospital. This is thought likely to have huge implications, particularly for small hospitals.

“We don't have a strategy in place. I don't have solutions,” he told delegates last week at a conference on the European working time directive organised by the BMA's Junior Doctors Committee.

The directive, which includes the clause that doctors in training work a maximum of 48 hours a week, will be …
Pemphigus vulgaris in siblings: HLA-DR4 and HLA-DQw3 and susceptibility to pemphigus
Authors: P.B. Reohr, A. Mangklabruks, A.M. Janiga, L.J. DeGroot, Y. Benjasuratwong, K. Soltani
Journal: Journal of the American Academy of Dermatology (1992)
Dietary Glycemic Index, Glycemic Load, Fiber, Simple Sugars, and Insulin Resistance: The Inter99 Study
Authors: Anette E. Buyken, Angela D. Liese
Journal: Diabetes Care (2005)

In their important analysis of data from the Inter99 Study on the relationship among glycemic index, glycemic load, and insulin resistance as estimated by the homeostasis model, Lau et al. (1) unfortunately do not provide adequate descriptive information on the distribution and variation in levels of glycemic index and glycemic load in their population. Additionally, the reader is left wondering about the associations of glycemic index and glycemic load with other (dietary) variables.

These types of information are critical for comparison and interpretation of the …
Abstract 4804: Identification of a functional network of human epigenetic silencing factors
Authors: Andrey S. Poleshko, Margret B. Einarson, Natalia Shalginskikh, Rugang Zhang, Peter D. Adams, Anna Marie Skalka, Richard A. Katz
Journal: Cancer Research (2010)

Abstract Epigenetic silencing directs transcriptional shutoff of specific genes during development and cellular differentiation. This process is mediated by epigenetic “marks” including DNA methylation and a variety of posttranslational histone modifications (e.g. methylation). Errors in placement or removal of epigenetic marks can drive epigenetic silencing and tumorigenesis. Inhibitors of DNA methyltransferase (DNMT) and histone deacetylase (HDAC) enzyme families (DNMTi and HDACi, respectively) can reverse epigenetic silencing and produce anti-tumor effects, possibly through reactivation of silent tumor suppressor genes (so-called epigenetic therapy). As these inhibitors show little specificity within enzyme families, their precise mechanisms of action are not well understood. To identify cellular factors involved in maintenance of epigenetic silencing, HeLa cells harboring epigenetically silent GFP reporter genes were interrogated with an siRNA library targeting predicted epigenetic regulators, including potential activators, silencers, chromatin remodelers, and ancillary factors. Using this approach, individual, or combinatorial requirements for specific epigenetic silencing factors can be detected by measuring GFP reactivation after siRNA-based factor knockdown. In our analyses, we identified a specific subset of epigenetic factors that are candidates for participation in a functional epigenetic silencing network in human cells. These factors include the histone deacetylase HDAC1, the de novo DNA methyltransferase DNMT3A, components of the Polycomb PRC1 complex (RING1, HPH2), and the histone lysine methyltransferases KMT1E and KMT5C. Roles were also detected for two TRIM protein family members, the cohesin component Rad21, and the histone chaperone CHAF1A (CAF-1 p150). Remarkably, combinatorial knockdown of factors was not required for reactivation, indicating little functional redundancy. Consistent with this interpretation, knockdown of either KMT1E or CHAF1A resulted in a loss of multiple histone repressive marks and concomitant gain of activation marks on the promoter during reactivation. These results reveal how functionally diverse factors may cooperate to maintain gene silencing during normal development or in disease. Furthermore, the findings suggest an avenue for discovery of new targets for epigenetic therapies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4804.
Profiting from closure: the private finance initiative and the NHS
Authors: D. Price
Journal: BMJ (1997)

Private investment is efficient when it maximises the returns on capital. Public investment is efficient when it maximises returns within the constraints of public policy goals, like meeting the population's healthcare needs. Given these different aspirations, what does partnership between the private and public sectors mean in practice? Specifically, what happens when private finance funds hospital redevelopment, as the private finance initiative attempts to do? In a BMA report published this week, Declan Gaffney and Allyson Pollock of St George's Hospital Medical School address this question in what is the most detailed independent study to date of the 14 private finance initiative schemes approved in June this year.1 Reliance on private investment, the authors say, inflates the scale of capital schemes to levels which far exceed more prudent public proposals as bidders try to improve their rate of return. This cost escalation puts new demands on public revenue, which in turn leads to the search for new economies and new subsidies. The economies inspire bed reductions and unpiloted innovations in healthcare provision, while the subsidies entail transfers from other health sectors and raids on the very public funds that private finance was meant to replace. Returns …
<i>TMPRSS2-ERG</i> Gene Fusion Is Not Associated with Outcome in Patients Treated by Prostatectomy
Authors: Anuradha Gopalan, Margaret A. Leversha, Jaya M. Satagopan, Qin Zhou, Hikmat A. Al-Ahmadie, Samson W. Fine, James A. Eastham, Peter T. Scardino, Howard I. Scher, Satish K. Tickoo, Victor E. Reuter, William L. Gerald
Journal: Cancer Research (2009)

A significant number of prostate cancers have been shown to have recurrent chromosomal rearrangements resulting in the fusion of the androgen-regulated TMPRSS2 promoter to a member of the ETS transcription factor family, most commonly ERG. This results in ERG overexpression, which may have a direct causal role in prostate tumorigenesis or progression. However, the clinical significance of the rearrangement is unclear, and in particular, relationship to outcome has been inconsistent in recent reports. We analyzed TMPRSS2-ERG gene rearrangement status by fluorescence in situ hybridization in 521 cases of clinically localized surgically treated prostate cancer with 95 months of median follow-up and also in 40 unmatched metastases. Forty-two percent of primary tumors and 40% of metastases had rearrangements. Eleven percent had copy number increase (CNI) of the TMPRRS2-ERG region. Rearrangement alone was associated with lower grade, but not with stage, biochemical recurrence, metastases, or death. CNI with and without rearrangement was associated with high grade and advanced stage. Further, a subgroup of cancers with CNI and rearrangement by deletion, with two or more copies of the deleted locus, tended to be more clinically aggressive. DNA index assessment revealed that the majority of tumors with CNI of TMPRSS2-ERG had generalized aneuploidy/tetraploidy in contrast to tumors without TMPRSS2-ERG CNI, which were predominantly diploid. We therefore conclude that translocation of TMPRSS2-ERG is not associated with outcome, and the aggressive clinical features associated with CNI of chromosome 21 reflect generalized aneuploidy and are not due to CNI specifically of rearranged TMPRSS2-ERG.
Differential and Opposing Regulation of PAI-1 Promoter Activity by Estrogen Receptor α and Estrogen Receptor β in Endothelial Cells
Authors: Layton Harris Smith, Stephen R. Coats, Hao Qin, Matthew S. Petrie, Joseph W. Covington, Ming Su, Mesut Eren, Douglas E. Vaughan
Journal: Circulation Research (2004)

To investigate the molecular mechanisms involved in the estrogen-dependent control of plasminogen activator inhibitor-1 (PAI-1) gene expression in vascular cells, we compared the transactivation properties of estrogen receptors (ERalpha and ERbeta) in regulating the activity of a human PAI-1 promoter reporter construct in transfected bovine aortic endothelial cells (BAECs). ERalpha increased PAI-1 promoter activity in BAECs by an estrogen-dependent mechanism, whereas ERbeta suppressed PAI-1 promoter activity by an estrogen-independent mechanism. The suppressive activity of ERbeta was dominant over the inductive activity of ERalpha. Mutation of a putative estrogen response element (ERE) located at position -427 in the proximal promoter abolished the ERalpha action without influencing the suppressive effects of ERbeta. Mutation of either AP1-like site did not eliminate the ERalpha or ERbeta actions at the PAI-1 promoter, suggesting that other promoter elements are involved in these responses. These mutations significantly reduced the -3.4kbp PAI-1 promoter response to serum. We concluded that ERalpha and ERbeta exert differential effects on the PAI-1 promoter activity in transfected BAECs. ERalpha activated the PAI-1 promoter through a proximal ERE (-427) and possibly additional EREs located within the PAI-1 promoter, whereas ERbeta suppressed the promoter construct via an unidentified mechanism. This is the first demonstration of the differential regulation of a vascular gene promoter by ERalpha and ERbeta.
MEASUREMENT OF TOTAL WATER EXCHANGE 1
Authors: L. H. Newburgh, Margaret Woodwell Johnston, Mark Falcon-Lesses
Journal: Journal of Clinical Investigation (1930)

Difference-the skin and lungs3 (insensible water).Table 1 is a water balance form that was found useful.The weights of each of these seven items of water were obtained in the following manner:A. The subject drank water as desired from a "thermos bottle" fitted with a rubber stopper.containing a glass drinking tube.The stoppered bottle filled with cold water was weighed at the beginning of the period and again at the end on a balance accurate to one gram.Less than one gram of water evaporated from the bottle in twenty- four hours.B. Several different diets were used.The best results were obtained when only milk and sucrose was fed.During this period, the 2The metabolic mixture consists of all the materials burned by the organism during the period and thus often includes body tissues.
GMC is accused of having altered the burden of proof in Southall case
Authors: C. Dyer
Journal: BMJ (2009)

The General Medical Council’s decision to strike the paediatrician David Southall off the medical register was “essentially geared to the maintenance of public confidence in the profession,” the GMC’s counsel, Robert Englehart QC, told the High Court in London last week.

A GMC fitness to practise panel found in December 2007 that Dr Southall was guilty of serious misconduct for accusing a mother of murdering her child and ordered him to be struck off ( BMJ 2007;335:1174; doi:10.1136/bmj.39420.690845.DB). He is appealing against the findings of fact, the misconduct decision, and the sanction of erasure.

“They weren’t saying this is a sanction which is required because patients are at risk,” said Mr Englehart. “They were saying this is a sanction which is right for this sort …
Abstract 4290: Visualizing immune surveillance in lung metastasis progression
Authors: M. Anna Zal, Todd Bartkowiak, Grzegorz Chodaczek, Veena Papanna, Meenakshi Shanmugasundaram, Tomasz Zal
Journal: Cancer Research (2012)

Abstract As stipulated by the Paget and Fuchs’ “seed and soil” analogy, the establishment of metastases depends on the microenvironment of target tissue; as such, it also depends on the tissue immunosurveillance system. Anti-tumor immune responses are subdued in advanced tumors by various immune suppressory mechanisms, such as by tumor associated CD4 FoxP3 regulatory T-reg cells. But how immune suppression sets in at the sites of metastasis, and how it could be overcome there remains unclear. Using multiphoton and confocal microscopy, we have visualized the immune cell's dynamics that is triggered by various metastatic cancers in the lungs. We found that single, blood-carried cancer cells that settle in the capillary bed triggered strikingly rapid recruitment of CD11c dendritic cells (DCs), which were heterogeneous. Some of those DCs wrapped around the singular cancer cells while other probed their intracellular content by acquiring tumor-derived vesicles. These phagocytic DCs then carried away their cargo towards the draining lymph nodes, thereby initiating tumor antigen cross-presentation. After 24-48 hours, micrometastases became surrounded by T cells that were highly enriched in T-reg. The motility patterns and cell depletion experiments showed that T-reg largely ignored tumor cells but were attracted by the phagocytic tumor-associated DCs. In result of these interactions, the phagocytic DCs became the foci of highly dynamic three-cell interactions between T-reg and the effector T cells, sequestering most T cells at the tumor margin. In this context, we tested the impact of immunomodulatory therapies. The immune cell dynamics that we uncovered in metastases was responsive to therapeutic immune modulation aimed at the tumor-associated phagocytic DCs and also at Programmed Death (PD-1) pathways. Taken together, our intravital dynamic imaging results highlight the duality of metastasis-associated phagocytic DCs. On the one hand, these cells provide tumor antigen cross-presentation and recruit T cells to nascent secondary tumors, but on the other hand, they aid metastasis progression by promoting early on the contact of tumor-infiltrating T cells with T-reg. 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 4290. doi:1538-7445.AM2012-4290
Suprapubic aspiration under ultrasound guidance in children with fever of undiagnosed cause
Authors: H Buys, L Pead, R Hallett, R Maskell
Journal: BMJ (1994)

To assess the ease of use of suprapubic aspiration of urine under ultrasound guidance in babies with fever of uncertain cause and to assess the importance of bacterial counts and pyuria in relation to abnormalities of the urinary tract and the importance of pyuria in the absence of bacteriuria.Analysis of urine samples obtained by suprapubic aspiration in babies and children from July 1991 to June 1992. The clinical records of the children with bacteriuria and sterile pyuria were examined retrospectively.Neonatal and paediatric wards of a district general hospital.508 babies and children who had fever of uncertain cause or were seriously ill.No difficulties arose in the collection of 545 specimens. Bacteria were isolated from the specimens of 44 children, 24 of whom had abnormalities of the urinary tract. The bacterial count was < 10(8)/l in 18 of the children with bacteriuria, 10 of whom had abnormalities. No white cells were seen in 22 of the 46 bacteriuric specimens; nine of the children with no pyuria had vesicoureteric reflux. 439 of the 499 non-bacteriuric specimens showed no white cells. 60 children had pyuria without bacteriuria.The use of ultrasound guidance simplifies suprapubic aspiration of urine in babies. Low bacterial counts may be associated with abnormalities of the urinary tract. Laboratory techniques capable of detecting such counts reliably should be used. Pyuria is absent in half of babies and very young children with bacteriuria. It rarely occurs without bacteriuria, and if it does an explanation should be sought.
Donald Barry Griffiths
Authors: Hugh Herbert
Journal: BMJ (2004)

Former consultant general surgeon Bronglais Hospital, Aberystwyth (b Colwyn Bay 1921; q University College Hospital, London, 1943; FRCS, MS), died from heart failure on 12 April 2004.​2004.




Figure 1




Donald Griffiths was consultant general surgeon in Aberystwyth from the 1960s. After house jobs and national service in west Africa and in Greece he worked in the professorial surgical unit at University College Hospital and held the John Marshall fellowship, University of London. He was president of the Aberystwyth division of the BMA in 1972. He played football for the Bronglais team and was chairman of Aberystwyth Football Club. Late in his career he developed a life threatening illness of his hands, attributed to the surgical gloves he had to wear, but recovered well. He leaves a wife, Mary; and five children.
Nutrition Principles for the Management off Diabetes and Related Complications
Authors: Marion J Franz, Edward S Horton, John P Bantle, Christine A Beebe, John D Brunzell, Ann M Coulston, Robert R Henry, Byron J Hoogwerf, Peter W Stacpoole
Journal: Diabetes Care (1994)

Health professionals and people with diabetes recognize nutrition therapy as one of the most challenging aspects of diabetes care and education (1). Adherence to meal planning principles requires the person with diabetes to learn specific nutrition recommendations. It may require altering previous patterns of eating and implementing new eating behaviors, which requires motivation for a healthy lifestyle and may also require participation in exercise programs. Finally, individuals must be able to evaluate the effectiveness of these lifestyle changes. Despite these challenges, nutrition is an essential component of successful diabetes management.