tbuckley/cabot-search huggingface dataset:
UK will lose clinical trials if electronic records system is delayed, ABPI warns
Authors: James Butcher
Journal: BMJ (2007)

Wiltshire police investigating unspecified allegations against a paediatrician at Southampton General Hospital are seeking expert medical evidence outside the UK.The case concerns a paediatrician who was involved in the care of a child whose mother was later charged with murder.Marianne Williams, then 22, was charged in 2004 with the murder of her 15 month old son, Joshua Taylor, whom she was alleged to have poisoned with salt.She was found not guilty in October last year after a six week trial at Winchester Crown Court.Wiltshire police officers are also under investigation for their role in the case.The Independent Police Complaints Commission said that it was "midway through" an investigation into a complaint about the conduct of the criminal investigation.Six officers had been served with official notice of the inquiry, although "this in no way implies guilt or wrongdoing on the part of any officer," the commission said.Detective Superintendent James Vaughan, the officer leading the Wiltshire force's inquiry into the allegations against the doctor, confirmed that Wiltshire Police would not be seeking medical advice in the case from any British doctors-a claim posted on the website forum Mothers Against Munchausen Allegations."In order to maintain the confidence of Joshua's family, and to identify an independent specialist who has had no connection with this or any other similar sets of circumstances in the United Kingdom, it has been necessary to seek assistance from overseas," Detective Superintendent Vaughan said.This was, he insisted, "not a reflection on the Wiltshire police's confidence in the United Kingdom experts."However, the Royal College of Paediatrics and Child Health said it was "confident that we have eminent experts in the UK who can offer an independent and authoritative opinion." Police look abroad for salt case expertUK NEWS Remedy UK loses court case, p1134
Mucormycosis in a Renal Transplant Recipient With Successful Outcome
Authors: Mario Henriquez
Journal: JAMA (1979)

MUCORMYCOSIS is usually a fatal disease that occurs in patients with uncontrolled diabetes mellitus, in patients with an abnormal immunologic system such as immunodeficiency states, or in patients receiving immunosuppressive drugs.<sup>1</sup>Few cases of mucormycosis have been reported in patients with renal transplants. With the increasing number of renal transplants in diabetics, mucormycosis may be seen in these patients. It is important to be aware of the clinical manifestations, diagnosis, and treatment of this fungal disease. A patient with juvenile-onset diabetes mellitus experienced mucormycosis with invasion of sinuses and hard palate two years after kidney transplantation. The patient responded to treatment with amphotericin B, surgical debridement of sinuses, and discontinuation of therapy with immunosuppressive drugs. <h3>Report of a Case</h3> A 20-year-old woman was admitted to the Albert Einstein Medical Center in October 1977 with the chief complaint of left frontal headache, malaise, and numbness in the left side of
Docetaxel and Estramustine Compared with Mitoxantrone and Prednisone for Advanced Refractory Prostate Cancer
Authors: Daniel P. Petrylak, Catherine M. Tangen, Maha H.A. Hussain, Primo N. Lara, Jeffrey A. Jones, Mary Ellen Taplin, Patrick A. Burch, Donna Berry, Carol Moinpour, Manish Kohli, Mitchell C. Benson, Eric J. Small, Derek Raghavan, E. David Crawford
Journal: New England Journal of Medicine (2004)

Mitoxantrone-based chemotherapy palliates pain without extending survival in men with progressive androgen-independent prostate cancer. We compared docetaxel plus estramustine with mitoxantrone plus prednisone in men with metastatic, hormone-independent prostate cancer.We randomly assigned 770 men to one of two treatments, each given in 21-day cycles: 280 mg of estramustine three times daily on days 1 through 5, 60 mg of docetaxel per square meter of body-surface area on day 2, and 60 mg of dexamethasone in three divided doses before docetaxel, or 12 mg of mitoxantrone per square meter on day 1 plus 5 mg of prednisone twice daily. The primary end point was overall survival; secondary end points were progression-free survival, objective response rates, and post-treatment declines of at least 50 percent in serum prostate-specific antigen (PSA) levels.Of 674 eligible patients, 338 were assigned to receive docetaxel and estramustine and 336 to receive mitoxantrone and prednisone. In an intention-to-treat analysis, the median overall survival was longer in the group given docetaxel and estramustine than in the group given mitoxantrone and prednisone (17.5 months vs. 15.6 months, P=0.02 by the log-rank test), and the corresponding hazard ratio for death was 0.80 (95 percent confidence interval, 0.67 to 0.97). The median time to progression was 6.3 months in the group given docetaxel and estramustine and 3.2 months in the group given mitoxantrone and prednisone (P<0.001 by the log-rank test). PSA declines of at least 50 percent occurred in 50 percent and 27 percent of patients, respectively (P<0.001), and objective tumor responses were observed in 17 percent and 11 percent of patients with bidimensionally measurable disease, respectively (P=0.30). Grade 3 or 4 neutropenic fevers (P=0.01), nausea and vomiting (P<0.001), and cardiovascular events (P=0.001) were more common among patients receiving docetaxel and estramustine than among those receiving mitoxantrone and prednisone. Pain relief was similar in both groups.The improvement in median survival of nearly two months with docetaxel and estramustine, as compared with mitoxantrone and prednisone, provides support for this approach in men with metastatic, androgen-independent prostate cancer.
Psychiatric tourism is overloading London beds
Authors: C. Tannock, T. Turner
Journal: BMJ (1995)

EDITOR,--A recent conference on metropolitan health care highlighted the plight of mentally ill people in London. Of special note was the serious shortage of admission beds in all urban areas in the United Kingdom,1 2 with the bed occupancy rate for mental health now well above 100%, with some units actually running at over 120%.3 Pressure seems greatest in inner London, and it is a far cry from the therapeutic standard of a bed occupancy rate no greater than about 85%.4 Such occupancy would allow patients to be placed in their catchment area ward, with effective aftercare and an allocated key worker, as envisaged in the care programme approach.

This shortage …
Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study
Authors: J. D Sargent, M. L Beach, M. A Dalton, L. A Mott, J. J Tickle, M B. Ahrens, T. F Heatherton
Journal: BMJ (2001)

It is known that 1) elevated serum bile acids (BAs) are associated with decreased body weight, 2) elevated glucagon-like peptide-1 (GLP-1) levels can decrease body weight, and 3) germ-free (GF) mice are resistant to diet-induced obesity. The purpose of this study was to test the hypothesis that a lack of intestinal microbiota results in more BAs in the body, resulting in increased BA-mediated transmembrane G protein–coupled receptor 5 (TGR5) signaling and increased serum GLP-1 as a mechanism of resistance of GF mice to diet-induced obesity. GF mice had 2- to 4-fold increased total BAs in the serum, liver, bile, and ileum. Fecal excretion of BAs was 63% less in GF mice. GF mice had decreased secondary BAs and increased taurine-conjugated BAs, as anticipated. Surprisingly, there was an increase in non–12<i>α</i>-OH BAs, namely, <i>β</i>-muricholic acid, ursodeoxycholic acid (UDCA), and their taurine conjugates, in GF mice. Further, in vitro experiments confirmed that UDCA is a primary BA in mice. There were minimal changes in the mRNA of farnesoid X receptor target genes in the ileum (Fibroblast growth factor 15, small heterodimer protein, and ileal bile acid–binding protein), in the liver (small heterodimer protein, liver receptor homolog-1, and cytochrome P450 7a1), and BA transporters (apical sodium dependent bile acid transporter, organic solute transporter <i>α</i>, and organic solute transporter <i>β</i>) in the ileum of GF mice. Surprisingly, there were marked increases in BA transporters in the large intestine. Increased GLP-1 levels and gallbladder size were observed in GF mice, suggesting activation of TGR5 signaling. In summary, the GF condition results in increased expression of BA transporters in the colon, resulting in 1) an increase in total BA concentrations in tissues, 2) a change in BA composition to favor an increase in non–12<i>α</i>-OH BAs, and 3) activation of TGR5 signaling with increased gallbladder size and GLP-1.
Effect of glucocorticoid receptor antagonist RU 38486 on acute glucocorticoid-induced insulin resistance in rat adipocytes
Authors: Tatsuo Ishizuka, Toshihiko Nagashima, Kazuo Kajita, Atsushi Miura, Mayumi Yamamoto, Satomi Itaya, Yoshinori Kanoh, Masayoshi Ishizawa, Hiroshi Murase, Keigo Yasuda
Journal: Metabolism (1997)
England short of 970 GPs
Authors: S. Mayor
Journal: BMJ (2003)

A survey by the British Medical Association has revealed that 3.4% of general practitioner posts in England have been vacant for three months or more, representing a shortage of 970 GPs. A total of 14 trusts have three month vacancy rates that are more than double the national average.

The BMA survey of 89 primary care trusts in England showed that the highest vacancy rates for GPs were in Greenwich primary care trust (south east London), with a three month …
The Lasègue Test
Authors: Jesse N. Borden
Journal: JAMA (1967)

To the Editor:—  As orthopedic consultant to a disability-evaluation agency, I analyze medical reports from physicians, specialists, and generalists throughout the country. The Lasegue test is commonly used in the physical examination of patients with low back impairments. It is evident that the method of performance of this diagnostic maneuver varies with the physician.  Reference to the original literature revealed the following facts.  The Lasegue test consists of two maneuvers. First, a passive straight-leg-raising test is carried out (Fig 1). Then as the second, and verification maneuver, the leg is again raised (jack-knifed) but with the knee flexed (Fig 2). Whereas the first maneuver will produce back and/or leg pain in the presence of low back pathology, the second maneuver can be carried out without the production of pain.  A positive Lasegue sign therefore consists of (1) the production of an anatomically proper pain on straight-leg raising and (2) absence
An audit of clinical outcome for patients with community-acquired pneumonia treated with combinations of benzylpenicillin, chloramphenicol and doxycycline
Authors: J. Allen, S. Cole, K. Hand, S. Herbert, J. Hinton, N. Ismail, R. Limbrey, B. Marshall, O. Morris, K. O'Reilly, S.M. Yusuf
Journal: Journal of Infection (2011)
Birt-Hogg-Dubé syndrome: clinical and genetic studies of 10 French families
Authors: N. Kluger, S. Giraud, I. Coupier, M.-F. Avril, O. Dereure, B. Guillot, S. Richard, D. Bessis
Journal: British Journal of Dermatology (2009)

Background Birt–Hogg–Dubé syndrome (BHDS) is an autosomal dominant genodermatosis predisposing to the development of multiple fibrofolliculomas (FFs), pulmonary cysts, spontaneous pneumothorax and renal neoplasms. The association of BHDS with various nonrenal neoplasms has been reported but remains controversial. Objectives To report the clinical features and germline mutations in 22 patients from 10 unrelated families with BHDS investigated during a 5-year prospective study by the Department of Dermatology at the University Hospital of Montpellier, France. Also, to define more clearly the characteristics of pulmonary, thyroid, renal and colorectal manifestations associated with BHDS. Methods Twenty-two patients with clinical and histological criteria of BHDS confirmed by FLCN (previously BHD) germline mutation were evaluated. Lung cysts and pneumothorax were detected by thoracic computed tomography (CT) scanning. Abdominal magnetic resonance imaging (MRI) or CT scans and/or renal ultrasonography were performed to screen for tumours. Thyroid nodules and goitres were assessed by clinical examination, ultrasound imaging and measurement of serum thyroid-stimulating hormone and thyrocalcitonin. Results Eighteen of the 22 individuals affected by BHDS (82%) were diagnosed with five or more FFs. Multiple epidermal cysts, severe facial hyperseborrhoea and oral papules were noted, respectively, in three of 22 (14%), nine of 22 (41%) and nine of 21 patients (43%). Spontaneous pneumothorax was reported in seven affected patients (32%). Cystic lesions were detected in 14 of 20 patients (70%) and mainly displayed a subpleural and basal location. Renal ultrasound, CT scan and/or MRI revealed renal cysts in 10 patients (45%), without renal carcinoma diagnosed thus far. Thyroid nodules and/or cysts were disclosed by ultrasound examination in 13 of 20 cases (65%). No medullary carcinoma or other thyroid carcinomas were detected. Colonoscopy failed to detect colorectal carcinoma. Conclusions We report here the largest series to date of French patients with BHDS. We noted a high prevalence of thyroid nodules and renal cysts. However, the lack of a control group does not allow assessment of whether or not such association with BHDS is fortuitous.
Synergistic effects of dual Zn/Ag ion implantation in osteogenic activity and antibacterial ability of titanium
Authors: Guodong Jin, Hui Qin, Huiliang Cao, Shi Qian, Yaochao Zhao, Xiaochun Peng, Xianlong Zhang, Xuanyong Liu, Paul K. Chu
Journal: Biomaterials (2014)
Hydroxyurea corrects the dysregulated L-selectin expression and increased H2O2 production of polymorphonuclear neutrophils from patients with sickle cell anemia
Authors: Malika Benkerrou, Charlotte Delarche, Lamia Brahimi, Michèle Fay, Etienne Vilmer, Jacques Elion, Marie-Anne Gougerot-Pocidalo, Carole Elbim
Journal: Blood (2002)
1128-124 Predictive validity of criteria for the epidemiological diagnosis of heart failure in the elderly: The icare dicomano study
Authors: Mauro Di Bari, Claudia Pozzi, Maria Chiara Cavallini, Loredana Staglianò, Chiara Bellotto, Barbara Crovetti, Riccardo Pini, Giulio Masotti, Niccolò Marchionni
Journal: Journal of the American College of Cardiology (2004)
Effect of lactulose on cerebral metabolism in patients with chronic portosystemic encephalopathy
Authors: I. M. James, M. Garassini
Journal: Gut (1971)

Cerebral blood flow and cerebral metabolism were studied in six patients with moderately severe portosystemic encephalopathy before and after a 10-day course of lactulose. As a result of therapy there was a mean increase in cerebral oxygen utilization but no changes in either mean glucose consumption or in mean cerebral blood flow. It appears therefore that the abnormalities in cerebral metabolism that have been previously described in patients with hepatic encephalopathy can be improved by the oral administration of lactulose.
Tetanus Following Vaccination.
Authors: Joseph McFarland
Journal: JAMA (1902)

Philadelphia, Pa., Jan. 21, 1902. <h3>To the Editor:</h3> —I will be greatly obliged to any of your readers who may have had or know of cases of tetanus following vaccination, if they will communicate with me concerning them. I am engaged in a critical analysis of such cases in the hope of determining their etiology, and desire to secure all the data possible. Respectfully yours,
278 BLOOD GLUCOSE AND GLYCOSYLATED HAEMOGLOBIN ARE INSENSITIVE DIAGNOSTIC INDICATORS OF GLUCOSE INTOLERANCE IN PATIENTS WITH CIRRHOSIS
Authors: K.J. Rhee, K.A. Chandarana, R. Ruparelia, E. Woolman, S. Kanagalingam, M. Thomas, M.Y. Morgan
Journal: Journal of Hepatology (2008)
THE ACTIVATION OF SKIN GRAFTS
Authors: Peyton Rous
Journal: The Journal of Experimental Medicine (1946)

Rabbit skin rendered hyperplastic by various agents showed less tendency than normal skin to contract when sliced off, and when used for grafts it united with the bed more rapidly and was vascularized sooner. The stimulated epidermis proliferated practically at once, and abundantly, to cover adjacent raw surfaces. Also the donor area healed much more swiftly than usual and became infected less often. Certain grave limitations and hazards encountered during the experiments with hyperplastic grafts are considered.
Compartmentalization of the Inflammatory Response during Acute Pancreatitis
Authors: Thierry L. Dugernier, Pierre-François Laterre, Xavier Wittebole, Jean Roeseler, Dominique Latinne, Marc S. Reynaert, Jérôme Pugin
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Local and systemic inflammation has been implicated in the pathogenesis of acute pancreatitis and secondary multisystem organ failure. To assess the pro- and antiinflammatory response, the site of mediator production, and their route of diffusion, we sampled simultaneously ascites, thoracic lymph, and blood at the onset of end-organ dysfunction and for the following 6 days in 60 patients with acute pancreatitis. We used immunoassays to measure pro- and antiinflammatory cytokines and cell-based bioassays to assess the net pro- and antiinflammatory activity elicited by the biological fluids. Tumor necrosis factor-alpha and interleukin-1beta were detected in less than 15% of blood and lymph samples. Secondary pro- and antiinflammatory cytokines were found to be elevated early and throughout the sampling period in all compartments. Cytokine levels decreased from ascites to lymph to blood, suggesting a splanchnic origin. Prolonged diversion of ascites and lymph did not alter cytokine gradients, suggesting mediator transfer via the splanchnic blood circulation. Although a net proinflammatory activity ascribed to interleukin-1beta was detected in ascites, a net antiinflammatory activity was measured in virtually all lymph and blood samples, suggesting that the pancreas and the splanchnic area are sites of a proinflammatory response and that an early, dominant, and sustained antiinflammatory activity takes place in circulating compartments.
Bone density and risk of hip fracture in men and women: cross sectional analysis
Authors: C. E D H De Laet, B. A van Hout, H. Burger, A. Hofman, H. A P Pols
Journal: BMJ (1997)

The pharmacokinetics of salicylamide elimination has been studied in healthy adult males and in two infants. Salicylamide is eliminated mainly by biotransformation to the glucuronide and the sulfate. The fraction of a dose which is excreted as salicylamide sulfate decreases with increasing dose, whereas the fraction excreted as glucuronide increases with increasing dose. The maximum excretion rate of salicylamide sulfate approaches a limiting value when 0.6 to 1.0 g of salicylamide is administered orally in rapidly absorbed form (solution) to adults. The limiting factor appears to be the availability of sulfate, since concomitant administration of L-cysteine increases the maximum excretion rate and the total excreted amount of salicylamide sulfate. Gentisamide glucuronide is a minor metabolite which appears in significant amounts only when salicylamide sulfate formation is restricted by the limited capacity of this process. Salicylamide in slowly absorbed form (pellets) yields larger amounts of salicylamide sulfate than the same dose in rapidly absorbed form (solution). These findings explain many of the apparent conflicts in previous reports on the metabolic fate of salicylamide in man, and they demonstrate that the metabolic fate of a drug which is eliminated by competing apparent zero-and first-order processes is a function of dose and dosage form, among other factors.
Edema Universalis(?)—Varia.
Authors: Gustavus M. Blech.
Journal: JAMA (1897)

Detroit, Mich., Nov. 5, 1897.  To the Editor:  —A year or so ago I was called to see a baby three months old having pronounced edema of the extremities, anasarca of the scrotum and a general puffiness of the eyelids, face, etc. The urine on chemic and microscopic examination showed no abnormality to account for the affection. Heart and lungs normal.  Recently Dr. Steinbrecher of this city, in his regular family practice, saw a somewhat similar case, save that there was no anasarca of the scrotum. Heart and kidneys were normal in this case also.  In the literature at my command, containing the most recent and voluminous reference works, I fail to find a description of a similar condition and would therefore ask you whether or not I am justified in calling it edema universalis?  I approve of your continued efforts to establish a department of health. Such an organization
Randomized, Controlled Trial to Improve Self-Care in Patients With Heart Failure Living in Rural Areas
Authors: Kathleen Dracup, Debra K. Moser, Michele M. Pelter, Thomas S. Nesbitt, Jeffrey Southard, Steven M. Paul, Susan Robinson, Lawton S. Cooper
Journal: Circulation (2014)

Background— Patients with heart failure (HF) who live in rural areas have less access to cardiac services than patients in urban areas. We conducted a randomized, clinical trial to determine the impact of an educational intervention on the composite end point of HF rehospitalization and cardiac death in this population. Methods and Results— Patients (n=602; age, 66±13 years; 41% female; 51% with systolic HF) were randomized to 1 of 3 groups: control (usual care), Fluid Watchers LITE, or Fluid Watchers PLUS. Both intervention groups included a face-to-face education session delivered by a nurse focusing on self-care. The LITE group received 2 follow-up phone calls, whereas the PLUS group received biweekly calls (mean, 5.3±3.6; range, 1–19) until the nurse judged the patient to be adequately trained. Over 2 years of follow-up, 35% of patients (n=211) experienced cardiac death or hospitalization for HF, with no difference among the 3 groups in the proportion who experienced the combined clinical outcome ( P =0.06). Although patients in the LITE group had reduced cardiac mortality compared with patients in the control group over the 2 years of follow-up (7.5% and 17.7%, respectively; P =0.003), there was no significant difference in cardiac mortality between patients in the PLUS group and the control group. Conclusions— A face-to-face education intervention did not significantly decrease the combined end point of cardiac death or hospitalization for HF. Increasing the number of contacts between the patient and nurse did not significantly improve outcome. Clinical Trial Registration— http://www.clinicaltrials.gov . Unique identifier: NCT00415545.
Mitral valve prolapse and agoraphobia
Authors: M Mavissakalian, R Salerni, M E Thompson, L Michelson
Journal: American Journal of Psychiatry (1983)

Of 46 female agoraphobic patients, three had definite and four had probable mitral valve prolapse--a total prevalence of only 15%. There were no significant differences between patients with mitral valve prolapse and the rest of the sample on demographic and clinical variables, nor did the groups differ significantly on measures of psychological symptoms assessed before and after treatment. These negative findings support recent reports indicating that agoraphobia associated with mitral valve prolapse may be indistinguishable from agoraphobia without mitral valve prolapse.