tbuckley/cabot-search huggingface dataset:
Funding could be withheld from general practices if staff take part in day of action, trusts warn
Authors: H. Jaques
Journal: BMJ (2012)

General practices in London have been threatened with sanctions for breach of contract if they take part in industrial action on 21 June to protest over changes to the NHS pension scheme.

Local primary care trust clusters—which were formed last year as part of the government’s reorganisation of the NHS in England—have informed the practices in their areas that they will be expected to deliver their contracts “in full” on the day of action and that any practice that fails to provide either essential or additional services during core hours will be regarded as in breach of contract.

Letters to practices from the five primary care trust (PCT) clusters in London say that the local NHS may issue formal breach of contract notices and decide to withhold certain payments owed to the holder of the primary medical service contract as compensation for any …
The course of anorexia nervosa.
Authors: G. Patton
Journal: BMJ (1989)

Some promotional claims are excessive-for instance, "the time required ... to conduct an initial diagnostic interview can be reduced from 1-1-5 hours to approximately 15 minutes" (Blouin AG, Walsh G, Perez E, Computerized DSM-III diagnosis: C-DIS, Ottawa Civic Hospital).There are even claims that one system "can diagnose schizophrenia in five minutes."6There is, however, only modest agreement (kappa values from 0-06 to 0 60) between diagnoses on the basis of clinical assessment and of computer assessment,59 leading to the conclusion that "it would be inappropriate to use [the computer] alone for diagnosis."I'A puzzled disappointment has arisen among proponents of these assessments because other doctors have not used them. 10he reluctance has been attributed to conservatism and apprehension about information technology, which ignores doubts about the clinical validity of the assessments.Also many oppose computerised assessments because they fear a loss of human communication" and believe that the only motive for using them is to reduce costs.These fears are fuelled when enthusiasts call their systems "interviews"'4 I 7_ in fact they are simply multiple choice questionnaires, albeit in an elegant format.A medical interview is more than a means of gathering information and of diagnosis; rather "it is an interaction between two people and ought to be as meaningful for the person who answers the questions as for the questioner."'2Most clinicians will not use these assessments until they have been carefully evaluated.Computerised assessments have an undoubted role in research and may prove to be of clinical value in collecting routine information, freeing doctors to use their time with patients more constructively.But satisfaction with treatment, compliance, and non-specific healing effects are all closely related to the doctor-patient relationship.In medicine the consultation "is the beginning of therapy,"'2 and computerised assessments will not be useful if they are allowed to interfere with communication between patients and their doctors.
The pH And Osmolality of Intravenously Used Drugs
Authors: Jacobus W. Mostert
Journal: JAMA (1971)

<h3>To the Editor.—</h3> In their communication "The pH and Acidity of Intravenous Infusion Solutions" (<b>215</b>: 1937, 1971), Lebowitz et al echo the concern of Cronk<sup>1</sup>as well as the reassurances of Spodick et al<sup>2</sup>with respect to the acidity of intravenous infusions. The problem is just as relevant to drugs commonly injected intravenously (Table 1). Since these drugs and the infusion solutions investigated by Lebowitz et al have no ionization of their own, the free hydrogen ions giving the acid pH derive from a little carbonic acid ionization which has a buffering capacity amounting to essentially zero. On coming into contact with the highly buffered blood, the change in pH is not of any consequence. As an example, we mixed 10 ml of heparinized whole blood with 2 ml of ketamine (Ketaject) of pH 4.40 anaerobically, and found the pH had changed to 7.12. Thus, the average dose
HEREDITARY OSTEOPETROSIS OF THE RABBIT
Authors: Louise Pearce
Journal: The Journal of Experimental Medicine (1950)

The results of postmortem examination of cases of hereditary osteopetrosis of the rabbit together with histologic observations on organs and tissues other than the skeleton have been described. The principal findings were, first, those associated with the characteristic progressive anemia of the disease, such as extramedullary foci of hemopoietic tissue, lymphoid hyperplasia, and the occurrence of hemosiderin in the liver, spleen, and lymph nodes. There was a widespread tissue distribution of intense phosphatase staining and of fine calcium deposition, as would be expected in the circumstances of the profound skeletal abnormality (3). In advanced cases with established growth retardation, malnutrition, and deterioration, the tissues generally showed a decreased glycogen content. The large amount of parathyroid tissue found in both early and late cases suggested a state of hyperparathyroidism. Low serum calcium, high serum phosphorus and phosphatase levels (2), and a predominately osteoblastic reaction (3) were suggestive of hypoparathyroidism. The possibility that an involvement of the parathyroid glands was a basic or primary condition of the disease is discussed. Evidence of a disturbance of other endocrine glands was shown by the predominately acidophilic staining reaction of the colloid of the thyroid, an enlargement of the adrenals in which both cortex and medulla participated, and the tendency toward a basophilia of the anterior lobe of the pituitary. It was pointed out that before an explanation of the part played by the parathyroid glands in this disease could be made, other data, including particularly embryological studies, must be available. Similarly, an interpretation of other endocrine gland changes must await additional information.
Evidence for a positive role of SHIP in the BCR-ABL–mediated transformation of primitive murine hematopoietic cells and in human chronic myeloid leukemia
Authors: Xiaoyan Jiang, Matthew Stuible, Yves Chalandon, Andra Li, Wing Yiu Chan, Wolfgang Eisterer, Gerald Krystal, Allen Eaves, Connie Eaves
Journal: Blood (2003)
Science trumps politics on emergency contraception
Authors: Douglas Kamerow
Journal: BMJ (2013)

Phenolic antioxidants inhibit the induction of inflammatory cytokines by inflammatory stimuli. Here, we analyzed the mechanism by which the antioxidants inhibit LPS-induced expression of tumor necrosis factor α (TNFα) in macrophages. Hydroquinone and <i>tert</i>-butyl hydroquinone, prototypes of phenolic antioxidants, block lipopolysaccharide (LPS)-induced transcription of TNFα and a nuclear factor (NF)-κB–mediated reporter gene expression, suggesting NF-κB as a target in the inhibition. Analyses of the NF-κB activation pathway revealed that the antioxidants do not inhibit LPS-induced activation of the IκB kinase activity, degradation of IκBα, or translocation of activated NF-κB into the nucleus, but they do block the formation of NF-κB/DNA binding complexes. In vitro experiments showed that the antioxidants do not directly interfere with DNA binding of NF-κB. Structure-activity analyses suggest that inhibition of NF-κB function involves the redox cycling property of the antioxidants. These findings implicate a redox-sensitive factor important for the binding of NF-κB to its DNA recognition sequence as a target molecule in the inhibition of NF-κB function and inflammatory cytokine expression by phenolic antioxidants.
Unique antigen of cultured Hodgkin's cells. A putative sialyltransferase.
Authors: E Paietta, R J Stockert, A G Morell, V Diehl, P H Wiernik
Journal: Journal of Clinical Investigation (1986)

Hodgkin's disease-derived giant cell lines (HD-cells) express high levels of ectosialyltransferase activity presumed to be a galactose-specific lectin recognizing the desialylated 3-fucosyl-N-acetyllactosamine structure (X-hapten). Both the anti-X-hapten monoclonal antibody VIM-D5 and a polyclonal antiserum to another galactose-lectin, the hepatic asialoglycoprotein receptor (HBP), recognize a 55,000-mol wt HD-cell protein (Paietta, E., R. J. Stockert, A. G. Morell, V. Diehl, and P. H. Weirnik. 1986. Proc. Natl. Acad. Sci. USA. 83:3451-3455.) That the expression of the 55,000-mol wt protein is restricted to HD-cells among X-hapten positive cells lines is confirmed in this study. The 55,000-mol wt protein is shown to be present on the cell surface and intracellularly, where an additional immunocrossreactive 150,000-mol wt protein is recognized. Extraction of the 55,000 mol wt protein from HD-cell lysates by affinity chromatography results in the loss of sialyltransferase activity. While evidence for a single protein possessing both the antigenic and the enzymatic activity is not direct, these results suggest that the ectosialyltransferase unique to HD-cells is a 55,000-mol wt membrane glycoprotein possessing the X-hapten oligosaccharide.
Morphology of heart valves preserved by liquid nitrogen freezing.
Authors: L C Armiger, R W Thomson, M G Strickett, B G Barratt-Boyes
Journal: Thorax (1985)

As a preliminary to establishing a frozen valve bank for replacement surgery, the possible effects of the proposed freezing and thawing procedure on tissue structure were assessed in 16 human pulmonary valves removed from cadavers at necropsy and nine dog valves obtained fresh. The valves were frozen and stored in liquid nitrogen for intervals ranging from 23 to 380 days. Blocks of tissue cut from the central area of one leaflet, and including some adjacent arterial wall and ventricular myocardium, were obtained both before freezing and after thawing and examined by a large specimen resin embedding technique for light and electron microscopy, with histochemical staining for matrix material. Control and thawed tissue from all valves appeared similar, indicating good preservation irrespective of storage time. Fine structural alterations in the cellular elements correlated with the total interval of autolysis (from death to freezing) rather than the cause of death or other variables and were not uniform in any of the specimens.
Systemic administration of a recombinant adenovirus encoding a HSA–Angiostatin kringle 1–3 conjugate inhibits MDA-MB-231 tumor growth and metastasis in a transgenic model of spontaneous eye cancer
Authors: C Bouquet, E Frau, P Opolon, E Connault, M Abitbol, F Griscelli, P Yeh, M Perricaudet
Journal: Molecular Therapy (2003)

We previously reported that intratumoral injection of AdK3, a recombinant adenovirus encoding human angiostatin kringle (K) 1 to 3, inhibits tumor vascularization and tumor growth. To reduce the serum clearance of this factor, we constructed an adenovirus (AdK3-HSA) that carries a chimeric gene encoding a fusion protein between angiostatin K1–3 and human serum albumin (HSA). This conjugate inhibited endothelial cell proliferation as efficiently as K1–3. K3–HSA serum concentrations in immunodeficient mice systemically injected with AdK3-HSA were dramatically higher than in AdK3-injected mice. Furthermore, the growth of MDA-MB-231 tumors grafted into nude mice that had been injected intravenously with AdK3-HSA was inhibited by 79% (versus 17% with AdK3). In TRP-1/SV40 Tag transgenic mice, which spontaneously develop eye tumors with brain metastases, intravenous injections of AdK3-HSA in newborn mice blocked metastatic dissemination efficiently and significantly, and prolonged survival by 3 weeks. After 2 months, only 46% of AdK3-HSA-treated animals developed micrometastases, whereas 94% of the AdCO1-injected group displayed numerous macrometastases. Nevertheless, ocular tumor growth was not modified because of impaired diffusion of the conjugate in the eye compartment. Our results show that HSA genetic coupling is an efficient way to increase the pharmacokinetics of circulating angiogenic inhibitors and thus their antitumoral activity.
Jerusalem court dismisses $2.2bn lawsuit against tobacco companies
Authors: J. Siegel-Itzkovich
Journal: BMJ (2011)

An Israeli Supreme Court panel of three judges threw out a lawsuit worth $2.2bn (£1.4bn; €1.6bn) on 13 July brought by Israel’s largest public health maintenance organisation against Israeli, British, and US tobacco conglomerates for treating its members with smoking relating illnesses.

Clalit Health Services, which has some 3.5 million members, filed the claim in 1998, at the time …
Intended place of delivery and perinatal outcome.
Authors: J Fedrick
Journal: BMJ (1978)

Data from the "1958 Perinatal Mortality Survey" have been analysed to assess differences in stillbirth and neonatal death rates according to the arrangements made for delivery. Only women aged 20-34 delivering at term, with no pregnancy abnormalities, were selected from three groups of women (normotensive primiparae, hypertensive primiparae, and normotensive women of parity 1, 2, or 3). Despite the fact that within each group the women booked for NHS consultant units were heavily weighted with adverse factors, the death rate of their infants was no more than 70% of that found among the women booked for either domiciliary, general practitioner unit, or private consultant delivery. Care and delivery in a NHS consultant unit carries least risk of death for the infant.
Substance P induces adverse myocardial remodelling via a mechanism involving cardiac mast cells
Authors: Giselle C. Meléndez, Jianping Li, Brittany A. Law, Joseph S. Janicki, Scott C. Supowit, Scott P. Levick
Journal: Cardiovascular Research (2011)

Substance P and neurokinin A (NKA) are sensory nerve neuropeptides encoded by the TAC1 gene. Substance P is a mast cell secretagogue and mast cells are known to play a role in adverse myocardial remodelling. Therefore, we wondered whether substance P and/or NKA modulates myocardial remodelling via a mast cell-mediated mechanism. Volume overload was induced by aortocaval fistula in TAC1−/− mice and their respective wild types. Left ventricular internal diameter of wild-type (WT) fistulas increased by 31.9%; this was prevented in TAC1−/− mice (4.2%). Matrix metalloproteinase (MMP) activity was significantly increased in WT fistula mice and was prevented in TAC1−/− mice. Myocardial collagen volume fraction was decreased in WT fistula mice; this collagen degradation was not observed in the TAC1−/− group. There were no significant differences between any groups in tumour necrosis factor (TNF)-α or cell death. Cardiac mast cells were isolated from rat hearts and stimulated with substance P or NKA. We found that these cells degranulated only to substance P, via the neurokinin-1 receptor. To determine the effect of substance P on mast cells in vivo, volume overload was created in Sprague-Dawley rats treated with the NK-1 receptor antagonist L732138 (5 mg/kg/day) for a period of 3 days. L732138 prevented: (i) increases in cardiac mast cell density; (ii) increased myocardial TNF-α; and (iii) collagen degradation. Our studies suggest that substance P may be important in mediating adverse myocardial remodelling secondary to volume overload by activating cardiac mast cells, leading to increased TNF-α and MMP activation with subsequent degradation of the extracellular matrix.
Coactivator function of RIP140 for NFκB/RelA-dependent cytokine gene expression
Authors: Inka Zschiedrich, Ulrike Hardeland, Anja Krones-Herzig, Mauricio Berriel Diaz, Alexandros Vegiopoulos, Johannes Müggenburg, Dirk Sombroek, Thomas G. Hofmann, Rainer Zawatzky, Xiaolei Yu, Norbert Gretz, Mark Christian, Roger White, Malcolm G. Parker, Stephan Herzig
Journal: Blood (2008)
Textbook of Rheumatology
Authors: J. T. Scott
Journal: Annals of the Rheumatic Diseases (1981)

arranged logically, and is considerably enhanced by clear and attractive line drawings by W. Brennan.The reader is not plunged into a mass of detail on individual aids but asked first, Is a hoist really necessary?While few doctors will require detailed knowledge of individual hoists, slings, and accessories, most working with patients with mobility problems would find this chapter a highly readable source of information on transferring and on toileting difficulties and their solution.This information obviously derives from Miss Tarling's experience in the Disabled Living Foundation and the Newcastle Aids Centre, and indicates the value of aids centres.Such advice is not easily obtainable elsewhere.The book deals with the use of hoists in virtually every situation, in hospital, at home, at work, and in transit.It should be available in all departments of rehabilitation, to all who are concerned with the ordering of hoists, and all who must use them, in which case its use should be reinforced by practical training.
A GLIMPSE OF THE HISTORY OF MILITARY SURGERY.
Authors: JOHN B. HAMILTON
Journal: JAMA (1897)

At the meeting of this Society in Chicago last fall; one of these pleasant reunions which I had the honor to attend, it was suggested that a paper on the history of military surgery would be of interest, and I was asked by your distinguished President if I would write a brief essay on this topic. Fortunately for the Society, he used the word brief, and all of us know what it is to obey a command. Another fortunate thing in the matter was, that it would have been impossible I think to have made it otherwise, in view of the smallness of the material at hand. If, however, the idea had been to write upon the many virtues and important position occupied by departed worthies who had filled places in military surgery, the task would have been easy. I confess my astonishment at the paucity of medical literature on
The emb operon, a gene cluster of Mycobacterium tuberculosis involved in resistance to ethambutol
Authors: Amalio Telenti, Wolfgang J. Philipp, Srinand Sreevatsan, Claudia Bernasconi, Kathryn E. Stockbauer, Brigitte Wieles, James M. Musser, William R. Jacobs
Journal: Nature Medicine (1997)
Counter-regulatory responses to continuous and intermittent therapy with nitroglycerin.
Authors: J D Parker, B Farrell, T Fenton, M Cohanim, J O Parker
Journal: Circulation (1991)

BACKGROUND Vasodilator therapy may be associated with reflex counter-regulatory responses, and these responses may play a role in the development of tolerance to nitroglycerin (GTN). METHODS AND RESULTS Standing systolic blood pressure, body weight, urinary sodium, and hormonal responses to continuous (n = 10) and intermittent (n = 10) transdermal GTN administration were studied in normal volunteers. There was rapid attenuation of the hypotensive response to transdermal GTN therapy in the continuous but not in the intermittent therapy group. Significant weight gain and sodium retention occurred during continuous but not during intermittent GTN therapy. This was accompanied by a greater decrease in hematocrit in the continuous group, a finding that suggests that plasma volume expansion occurred during continuous GTN therapy. Continuous GTN therapy was associated with increases in plasma norepinephrine, atrial natriuretic peptide, arginine, vasopressin, and plasma renin activity. A different pattern of neurohormonal response was seen during intermittent therapy, with values tending to return to baseline levels after the nitrate-free interval. CONCLUSIONS Continuous transdermal GTN therapy leads to counter-regulatory responses associated with sodium retention and probable plasma volume expansion. By contrast, intermittent transdermal GTN therapy is associated with a different pattern of hormonal response, the lack of sodium retention and no evidence of plasma volume expansion. It is likely that these counter-regulatory responses play an important role in the attenuation of nitrate effects.
Extensions, elaborations, and explanations of the role of evolution and learning in the control of social behavior
Authors: Michael Domjan, Brian Cusato, Ronald Villarreal
Journal: Behavioral and Brain Sciences (2000)

Reactions to the target article included requests for extensions and elaborations of the schema we proposed and discussions of apparent shortcomings of our approach. In general, we welcome suggestions for extension of the schema to additional kinds of social behavior and to forms of learning other than Pavlovian conditioning. Many of the requested elaborations of the schema are consistent with our approach, but some may limit its generality. Many of the apparent shortcomings that commentators discussed do not seem problematic. Our schema encourages a broad view of the behavioral consequences of Pavlovian conditioning – including learned modifications of responding to the unconditioned stimulus. Costs and benefits addressed by our schema are the long-range reproductive consequences of learning – not the immediate reinforcing consequences of particular conditioned responses. Our approach allows the evolution of learning to yield maladaptive behavior and can be extended to characterize dynamic social interactions. We clarify that ours is not a homeostatic model involving ideal set points, and we clarify and defend our application of Pavlovian concepts to the analysis of social play.
Activity of 9-[2-Hydroxy-1-(hydroxymethyl)ethoxymethyl]guanine in the Treatment of Cytomegalovirus Pneumonia
Authors: DAVID H. SHEPP
Journal: Annals of Internal Medicine (1985)

Ten marrow transplant recipients with biopsy-proven cytomegalovirus pneumonia were treated with the acyclic nucleoside analog 9-[2-hydroxy-1-(hydroxymethyl)ethoxymethyl]guanine (BW B759U). Viruria and viremia ceased after 4 days of treatment in all patients with cultures initially positive from these sites. Cytomegalovirus was eliminated from respiratory secretions after a median of 8 days. Despite this antiviral effect, only one patient survived the pneumonia. Quantitative cultures of lung tissue before and after treatment confirmed that therapy with BW B759U was associated with substantial antiviral activity, with a mean decrease in viral titers of more than 99.99% after treatment. Neutropenia developed in three patients when mean peak and trough plasma levels exceeded 50 and 10 µmol/L, respectively, but no other toxicity was seen. BW B759U is the first antiviral agent showing consistent activity against cytomegalovirus in vivo, and it should be evaluated in the earlier management of cytomegalovirus infections after marrow transplantation and in serious cytomegalovirus infections in other immunocompromised patients.