tbuckley/cabot-search huggingface dataset:
Surgical management of prolapse in elderly women.
Authors: E. G. Robertson, J. K. Russell
Journal: BMJ (1966)

Myocardial Ischaemia-Rosen et al. 3. E.C.G. changes suggestive of ischaemia were present pre- operatively in 52 per 1,000, and similar changes developed postoperatively in a further 38 per 1,000 who had a normal E.C.G. before operation.A total of 114 per 1,000 had either ischaemic changes or infarction.4. There is an apparent association between these E.C.G. changes and operation on the biliary tract, thyroid, upper abdomen, and herniae.5. Associations also appear to exist with long operations, vith preoperative hypertension, and possibly with obesity.6i There was no clear association between the E.C.G. changes and the type of anaesthetic, the occurrence of hypotension during the operation, and such factors as the stay in hospital and postoperative complications due to the surgical diseases.7. There was no clinical evidence of cardiac disturbance associated with the E.C.G. changes, except in one patient who developed postoperative myocardial infarction.8. Of all the patients in this study ( 506) 98 (20%), or 196 per 1,000, had some abnormality of the E.C.G. or had a history suggestive of ischaemic heart disease while in hospital.9. The study also revealed that 30% of our patients were moderately or severely hypertensive, and that 12% were more than 20% overweight.10.Although there was little clinical evidence of cardiac disturbance which could be associated with the great majority of these E.C.G. changes, nevertheless the proportion of surgical patients involved is not small.It is important, therefore, to know with more certainty than at present whether these E.C.G. changes indicate an effect on the prognosis of the patient.Long-term follow-up studies are needed.11.If the E.C.G. changes should prove to be of importance to the surgical team then every patient should have a preoperative and postoperative E.C.G. as well as a much better general clinical assessment than they do at present.In the meantime particular attention should be paid to the " markers " we have indicated, and perhaps more use should be made of E.C.G. monitors. SummaryA total of 506 surgical patients aged 35 to 66 years were studied from the point of view of myocardial ischaemia and ischaemic heart disease.Myocardial infarction was present in eight patients preoperatively, and developed in three after operation.In addition, E.C.G. changes suggestive of ischaemia were present preoperatively in 26 (5 %), and developed postoperatively in a further 19 (4 %).There was an apparent association between these changes and certain operative procedures, operations of longer duration, and preoperative hypertension.It is important to know whether these E.C.G. changes indicate an effect on the prognosis of the patient.In all, 98 (20%) patients had some abnormality of the E.C.G. or a history suggestive of ischaernic heart disease.Long-term follow-up studies are needed.We would like to acknowledge the invaluable collaboration of Mr.
Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD): The TRIPOD Statement
Authors: Gary S. Collins, Johannes B. Reitsma, Douglas G. Altman, Karel G.M. Moons
Journal: Annals of Internal Medicine (2015)

Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making. However, the overwhelming evidence shows that the quality of reporting of prediction model studies is poor. Only with full and clear reporting of information on all aspects of a prediction model can risk of bias and potential usefulness of prediction models be adequately assessed. The Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) Initiative developed a set of recommendations for the reporting of studies developing, validating, or updating a prediction model, whether for diagnostic or prognostic purposes. This article describes how the TRIPOD Statement was developed. An extensive list of items based on a review of the literature was created, which was reduced after a Web-based survey and revised during a 3-day meeting in June 2011 with methodologists, health care professionals, and journal editors. The list was refined during several meetings of the steering group and in e-mail discussions with the wider group of TRIPOD contributors. The resulting TRIPOD Statement is a checklist of 22 items, deemed essential for transparent reporting of a prediction model study. The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used. The TRIPOD Statement is best used in conjunction with the TRIPOD explanation and elaboration document. To aid the editorial process and readers of prediction model studies, it is recommended that authors include a completed checklist in their submission (also available at www.tripod-statement.org).
Palestinian health crisis will end only with withdrawal of Israel
Authors: C. Dyer
Journal: BMJ (2009)

Palestinians in the West Bank and Gaza Strip are enduring a chronic health crisis that will be fully alleviated only by an end to the occupation by Israel, a two year, peer reviewed study by an international team has concluded.

The report, written by a team of health scientists from Birzeit University, near Ramallah, West Bank—together with colleagues from the World Health Organization, United Nations agencies, and universities in the United States, the United Kingdom, Norway, and France—is described as the latest and most comprehensive assessment yet produced of the health of Palestinians.

Published by the Lancet , it points to numerous indicators of worsening health among the 3.8 million residents of the West Bank and the Gaza Strip, where women of reproductive age and children under …
ABO Blood Groups and Toxaemia of Pregnancy
Authors: M. G. Pearson, G. D. Pinker
Journal: BMJ (1956)

Coombs test was carried out on infants' cells sensitized in mothers' serum.No other incompatibility was detected.So far as we are able to analyse the figures, the first period, as shown above, consistently yields a fairly highly significant excess of 0 in toxaemia, the second period equally consistently yielded no such excess.It may be that there is a phenomenon to explain, but on the present evidence it seems likely that the original finding was due to chance.This experience serves to emphasize the need for large numbers in work in this field, the desirability of demanding a high level of significance before results are taken as more than an indication for further inquiry, and also the desir- ability of comparing results from different hospitals and different areas.Summary A further series does not confirm the finding (Pike and Dickins, 1954) that there is an excess of women of group 0 among those suffering from toxaemia of pregnancy.
Differentiation of Malignant and Benign Solitary Thyroid Nodules Using 30- and 120-Minute Tc-99m MIBI Scans
Authors: Rajnish Sharma, Anupam Mondal, L Ravi Shankar, M Sahoo, Parul Bhatnagar, K Sawroop, M K. Chopra, Ravi Kashyap
Journal: Clinical Nuclear Medicine (2004)

Technetium-99m methoxy isobutylisonitrate (MIBI) has been found to be taken up by various tumors, including thyroid cancer. We prospectively evaluated 77 patients with cold thyroid solitary nodules on Tc-99m pertechnetate scintigraphy to evaluate the diagnostic value of Tc-99m MIBI scintigraphy. The aim of this study was to find out if thyroid nodules can be characterized on the basis of retention of MIBI and whether preoperative evaluation of malignancy is possible using this method. Single injection, dual-phase (30 and 120 minutes) thyroid scintigraphy using Tc-99m MIBI was performed in all these patients. In the following days and weeks, all patients underwent surgery. Using the 120/30-minute thyroid lesion to background radiouptake ratio (RUR), malignant and benign thyroid nodules could be separated with a sensitivity, specificity, and positive predictive value of 84.4%, 95.45%, and 93.33%, respectively. The mean RUR for malignant thyroid lesions was found to be 1.57+/-0.32, whereas for benign lesions, the ratio was significantly lower, 0.32+/-0.19. In conclusion, fine needle aspiration cytology along with the 120/30 minutes Tc-99m MIBI scintigraphy ratio appears to be useful in the preoperative assessment of solitary thyroid nodules.
Low hematocrit predicts contrast-induced nephropathy after percutaneous coronary interventions
Authors: Eugenia Nikolsky, Roxana Mehran, Zoran Lasic, Gary S. Mintz, Alexandra J. Lansky, Yingbo Na, Stuart Pocock, Manuela Negoita, Issam Moussa, Gregg W. Stone, Jeffrey W. Moses, Martin B. Leon, George Dangas
Journal: Kidney International (2005)
Haplotype-tagging RANTES gene variants influence response to antiviral therapy in chronic hepatitis C†
Authors: Hermann E. Wasmuth, Alexa Werth, Tobias Mueller, Thomas Berg, Christoph G. Dietrich, Andreas Geier, Carsten Gartung, Johann Lorenzen, Siegfried Matern, Frank Lammert
Journal: Hepatology (2004)

The response to antiviral therapy for chronic hepatitis C virus (HCV) is complex and is determined by both environmental and genetic factors. Recently, interacting gene polymorphisms of the chemokine RANTES have been shown to affect HIV disease progression. Our aim was to assess if these RANTES variants are associated with response to anti-HCV therapy. Three linked RANTES single nucleotide polymorphisms (403 G/A, Int1.1 T/C, and 3' 222 T/C) were determined in 297 Caucasian patients who were treated for chronic HCV infection and 152 control subjects. Characteristic nucleotide combinations on single chromosomes (haplotypes) were reconstructed and tested for disease association. Four common RANTES haplotypes (prevalence > 3%) were identified in patients and controls [corrected]. There was a strong association of RANTES haplotype distribution with outcome of antiviral combination therapy (P = .007). Specifically, RANTES haplotypes carrying Int1.1 C and 3' 222 C alleles were more frequent in nonresponders than in patients with a sustained response to antiviral therapy (odds ratio 1.9, P = .01). The influence of these RANTES haplotypes on the outcome of therapy was more pronounced in patients infected with HCV genotypes 1 and 4 (odds ratio 2.3, P = .02). Because RANTES haplotypes carrying Int1.1 C are known to down-regulate RANTES transcriptional activity in vitro, the haplotype analysis fits the hypothesis of a diminished T helper 1 lymphocyte response in patients with a negative response to antiviral therapy. In conclusion, RANTES haplotypes might contribute to the polygenic interaction between HCV and the host immune system and could help to risk stratify patients prior to antiviral therapy.
Ten year follow-up of a randomised controlled trial of care in a stroke rehabilitation unit
Authors: Avril E R Drummond, Ben Pearson, Nadina B Lincoln, Peter Berman
Journal: BMJ (2005)

Our quantitative findings indicate that a minority of professionals would recruit to a trial comparing planned caesarean section with planned vaginal birth.However, the qualitative finding-that midwives who favoured a trial did so because of their confidence in the benefits of vaginal birth-adds complexity because it negates the necessary individual professional equipoise. 4 We explored the opinions of senior obstetricians and midwives simultaneously and nationally, and we identified views about a possible randomised trial.To gain unbiased views, we deliberately did not present participants with a protocol, rather than give the impression that a trial was planned.We also believe that evidence about benefits and risks is insufficient to develop a protocol.If caesarean birth were shown to be as safe as normal birth in a non-inferiority trial, the NHS would have to consider whether it would be willing to offer such a choice, given the huge resource implications. 2If the cost makes offering choice to all women unfeasible then carrying out a trial would be unethical.The ethical, moral, and practical challenges to a trial are considerable and would require involvement of women and society at large.The authors acknowledge the support of Ruth Cattrell, research midwife, all of the heads of midwifery, and consultant obstetricians who participated.
Short-term and long-term physical effects of exposure to CS spray
Authors: Y G Karagama, J R Newton, C J R Newbegin
Journal: Journal of the Royal Society of Medicine (2003)

CS gas (2-chlorobenzylidene malonitrile) is widely used in an incapacitant spray that causes intense lacrimation, blepharospasm and burning sensations in the throat and nose. Questions have been raised about its safety. We obtained information on short-term and long-term symptoms, and performed ear, nose and throat examinations and respirometry at 8-10 months, in 34 young adults who had been exposed to CS spray in a confined space during a confrontation with police. The group was subdivided into those who had been sprayed directly on the face (n=10) and those exposed indirectly. At one hour, all but 2 individuals still had symptoms; respiratory and oral symptoms were significantly more prevalent in the directly exposed group. At one month, only oral symptoms were significantly more prevalent. At 8-10 months, symptoms were still reported but there were no differences between the groups and clinical examinations revealed no specific abnormalities. There was no convincing evidence of long-term physical sequelae from exposure to CS spray.
Paediatrician David Southall wins appeal against GMC
Authors: C. Dyer
Journal: BMJ (2010)

The paediatrician David Southall has won his appeal against a General Medical Council finding that he was guilty of serious professional misconduct, in accusing a mother of murdering her 10 year old son, and against an order striking him off the medical register.

Three judges in the Court of Appeal ruled that the High Court judge Mr Justice Blake “fell into error” when he turned down Dr Southall’s original appeal last May ( BMJ 2009;338:b2144, doi:10.1136/bmj.b2144).

But the full effect of the judgment on the possibility of the paediatrician’s reinstatement to the medical register will not become clear until the court makes an order next week about what should happen next, after hearing submissions from his lawyers and from the GMC.

The GMC said, “Our understanding …
Abstract 3417: Class III HDAC induces epithelial-to-mesenchymal transition in prostate cancer cells
Authors: Vanessa Byles, Lijia Zhu, Laura K. Chmilewski, Jenna D. Lovaas, Douglas V. Faller, Yan Dai
Journal: Cancer Research (2011)

Abstract The epithelial-to-mesenchymal transition (EMT) is a crucial program for initiating invasion and metastasis in many epithelial tumors. EMT is characterized by loss of cell adhesion and increased cell mobility; however, the mechanism underlying this transition is not fully understood. Here we identified SIRT1, a class III histone deacetylase, as a critical regulator of EMT. We show that forced expression of SIRT1 disrupts the epithelial morphology in non-transformed prostate epithelial cells, concomitant with a decrease of epithelial marker E-cadherin, and an increase of mesenchymal protein N-cadherin, and fibronection expression, indicating EMT. In contrast, silencing SIRT1 expression in metastatic prostate tumor cells restores cell to cell adhesion and induces changes in morphology characteristic of epithelial cells, concomitant with an increase of E-cadherin and a decrease of N-cadherin and fibronection expressions. In addition, we show that SIRT1 represses the activity of the E-cadherin proximal promoter with an E-box dependent mechanism, indicating a connection between SIRT1 and the zinc-finger EMT transcription factor, which needs the E-box to suppress E-cadherin transcription. Moreover, we performed ChIP assays to show that SIRT1 and ZEB1 bind to the same DNA fragment on the E-cadherin promoter, and SIRT1 occupancy in the E-cadherin promoter requires ZEB1. In addition, we show that acetylated H3K9 levels were inversely related to occupancy of SIRT1 and ZEB1. Finally, our results show that SIRT1 knockdown reduces prostate cancer cell migration and invasion. Thus, in this study we identified SIRT1 as an important regulator of EMT and demonstrated a new transcriptional mechanism regulating E-cadherin expression by the cooperation of SIRT1 with ZEB1. These findings suggest that overexpressed SIRT1 in prostate cancer cells may be targeted to reverse EMT, and SIRT1 could be a potential target in the treatment of prostate cancer progression. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3417. doi:10.1158/1538-7445.AM2011-3417
How hospitals are built.
Authors: J Smith
Journal: BMJ (1984)

A consultant chosen to represent his or her colleagues on a project team for a new hospital is thrown head first into a bewilderingly complex activity. It is multidisciplinary, including not just the familiar faces of nurses and administrators but also architects, engineers, and quantity surveyors, who come with their own languages?of on costs and abnormals, DCPs, and universal envelopes and with rolled up plans covered in incomprehensible symbols. Most consultants will not have planned a hospital before, nor are they likely to again, but they will probably have to live with what they build. Their colleagues certainly will, both immediately and for years to come. So they need to learn fast. Because the users get only one chance to build their hospital they invariably want it to be perfect, which it won't be. At best it will be a workable compromise among many conflicting claims. v The project team's job is to draw up the brief for a scheme, which describes the size, the site, the content, and the work of the hospital, so that the designers can translate it into a building. This article is about planning a major new development. The principles apply, on a smaller scale, to smaller developments. If option appraisal works properly the need for a new building should have been identified through service planning. Option appraisal is the process of identifying a need, studying the costs and benefits of various ways of meeting that need, and selecting the best. Thus the project team itself should have a clear brief: know the aim of the hospital, know its content, and know the thinking behind the decisions. Although hospitals are built by regions, districts eventu? ally have to run them, and the DHSS now insists that they should show that they can afford to before they start planning a hospital. In practice this might mean consulting on closures eight or nine years before hospitals are actually due to close. ' If the chosen option is a nucleus hospital the project team still needs to know the reasons for the decision?whether it was a positive choice because of the advantages of using nucleus or whether the region was just bowing to the DHSS's encourage? ment to use nucleus. If the latter, the team may well have problems.
Routine Inquiry about Organ Donation — An Alternative to Presumed Consent
Authors: R M Veatch
Journal: New England Journal of Medicine (1991)

AS of April 1991, there were 22,842 people in the United States on the waiting lists for organs for transplantation.1 The list is getting longer each year. Many patients die waiting for organs. Others must be maintained on dialysis for want of a transplantable kidney. It is understandable that some people are growing impatient with the system of voluntary donation embodied in the Uniform Anatomical Gift Act — a law that requires specific consent for donation and that has been in place now for two decades.2 The idea of presuming that the deceased person would consent to the use of . . .
Lymphatic filariasis has been eliminated in 16 countries, monitoring indicates
Authors: M. Dean
Journal: BMJ (2008)

Lymphatic filariasis has probably been eliminated in 16 countries, including 12 in the Pacific, since an eradication drive was launched 10 years ago. 

The campaign, a private-public partnership involving two multinational drug companies, the World Health Organization, and many national governments, has treated 570 million people in 48 countries.

Some 21 Pacific countries—such as the Solomon Islands, Tonga, and American Samoa—with a population totalling seven million people have completed the five annual cycles needed to get rid of the disease, and monitoring sites indicate that at least two thirds of these countries will be entirely free of the disease and that mopping-up exercises should succeed in the others.

Several areas or countries in other regions have also completed the five annual cycles. Four are believed to be free of the disease: Zanzibar, Sri Lanka, Togo, and the Comoros Islands. Egypt, where the disease flourished 4000 years ago, has begun …
A Peptide Mimicking VGLL4 Function Acts as a YAP Antagonist Therapy against Gastric Cancer
Authors: Shi Jiao, Huizhen Wang, Zhubing Shi, Aimei Dong, Wenjing Zhang, Xiaomin Song, Feng He, Yicui Wang, Zhenzhen Zhang, Wenjia Wang, Xin Wang, Tong Guo, Peixue Li, Yun Zhao, Hongbin Ji, Lei Zhang, Zhaocai Zhou
Journal: Cancer Cell (2014)
Evidence on safety of implanted devices is often not publicly available, study finds
Authors: M. McCarthy
Journal: BMJ (2014)

Researchers have been unable to find documentation of the scientific evidence used to allow hundreds of medical devices to be marketed in the United States, despite requirements that such information be publicly available.1

Each year the US Food and Drug Administration allows about 400 medical devices onto the market without clinical trials, provided the manufacturers submit scientific evidence that the new devices are “substantially equivalent” to devices previously cleared by the agency—known as “predicates”—in a process called 510(k) clearance.

Unlike drugs, which the FDA requires to undergo clinical trials to demonstrate their safety and effectiveness, only about 1% of medical devices are required to undergo such rigorous pre-approval testing. The FDA requires no testing for about two thirds of devices, such as crutches and scalpels, which the agency designates as “low risk.” The remainder—about one third of devices, designated as “moderate to high risk”—are “cleared …
Microalbuminuria and diabetes.
Authors: D Killalea
Journal: BMJ (1993)

This is much higher than the expected incidence of under 2 per 1000 women years in the studies reviewed by Vessey for idiopathic venous throm- bosis, in users of mainly high dose oestrogen pills.2At present the teaching at the Margaret Pyke Centre is that sickle cell disease is a strong relative contraindication to all pills containing oestrogen.The report, indicating that thromboembolism requiring treatment by anticoagulation is a definite risk, strengthens me in that view.Thus, although I do not entirely disagree with the authors' con- clusion that "we do not consider [the combined contraceptive pill] to be contraindicated in this group of women as any complication should be balanced against the substantial risks of preg- nancy," my view is that, in Britain, the combined pill is a second best choice for most women with sickle cell disease, though not absolutely contra- indicated.Much to be preferred and even more effective if the woman accepted it after good counselling would be medroxyprogesterone acetate, which reduces the frequency of crises.3In Howard and colleagues' study only 26 women provided only 44 woman years of use of this contraceptive.Possibly the relevant community still considers it to be a suspect method because of previous adverse publicity, which was based largely on erroneous data.I hope that attitudes will change among both providers and users now that medroxypro- gesterone acetate has been approved in the United States.