tbuckley/cabot-search huggingface dataset:
Scottish GPs want no part of English "market driven" reforms
Authors: B. Christie
Journal: BMJ (2011)

Family doctors in Scotland are demanding greater influence over the care of their patients but are strongly opposed to the controversial health reforms being pursued in England.

The annual conference of Scottish local medical committees on 10 March agreed to explore models of GP commissioning but only after unanimously rejecting the “market driven healthcare policies of the UK coalition government.”

The conference was told that the health systems in Scotland and England are diverging to such an extent that England now appears more foreign to Scottish doctors than continental Europe.

The chairman of …
Communication of results of necropsies in north east Thames region.
Authors: P Whitty, C Parker, F Prieto-Ramos, S al-Kharusi
Journal: BMJ (1991)

To evaluate the adequacy of reporting of results of necropsy to referring clinicians and to general practitioners.Questionnaire survey of referring clinicians and general practitioners of deceased patients in four districts in North East Thames region. Patients were selected by retrospective systematic sampling of 50 or more necropsy reports in each district.One teaching hospital, one inner London district general hospital, and two outer London district general hospitals.70 consultants and 146 general practitioners who were asked about 214 necropsy reports; coroners' reports were excluded.Time taken for dispatch of final reports after necropsy, consultants' recognition of the reports, general practitioners' recognition of the reports or of their findings, and consultants' recall of having discussed the findings with relatives.Only two hospitals dispatched final reports including histological findings (mean time to dispatch 144 days and 22 days respectively). 42 (60%) consultants and 83 (57%) general practitioners responded to the survey. The percentage of reports seen by consultants varied from 37% (n = 13) to 87% (n = 36); in all, only 47% (39/83) of general practitioners had been informed of the findings by any method. Consultants could recall having discussed findings with only 42% (47/112) of relatives.Communication of results of necropsies to hospital clinicians, general practitioners, and relatives is currently inadequate in these hospitals.A report of the macroscopic findings should be dispatched immediately after necropsy to clinicians and general practitioners; relatives should routinely be invited to discuss the necroscopic findings. One department has already altered its practice.
Atopy after bone marrow transplantation.
Authors: J Tucker, R S Barnetson, O B Eden
Journal: BMJ (1985)

Une observation: un enfant de 9 ans atteint de leucemie aigue lymphoblastique, en 3 e  remission, recoit une greffe de moelle de son frere, HLA-identique et CML-negatif. Le frere donneur presente depuis l'âge de 4 mois des accidents allergiques, notamment apres ingestion de certains aliments. Le receveur, qui etait exempt de tout trouble allergique auparavant, presente apres la greffe les memes accidents. Il semble s'agir d'un transfert passif adoptif involontaire
Increased 99mTc-Sestamibi Washout Reflects Impaired Myocardial Contractile and Relaxation Reserve During Dobutamine Stress Due to Mitochondrial Dysfunction in Dilated Cardiomyopathy Patients
Authors: Daisuke Hayashi, Satoru Ohshima, Satoshi Isobe, Xian Wu Cheng, Kazumasa Unno, Hidehito Funahashi, Norihiro Shinoda, Takahiro Okumura, Akihiro Hirashiki, Katsuhiko Kato, Toyoaki Murohara
Journal: Journal of the American College of Cardiology (2013)
Levels of <i>SCS7/FA2H</i>-Mediated Fatty Acid 2-Hydroxylation Determine the Sensitivity of Cells to Antitumor PM02734
Authors: Ana B. Herrero, Alma M. Astudillo, María A. Balboa, Carmen Cuevas, Jesús Balsinde, Sergio Moreno
Journal: Cancer Research (2008)

Abstract PM02734 is a novel synthetic antitumor drug that is currently in phase I clinical trials. To gain some insight into its mode of action, we used the yeast Saccharomyces cerevisiae as a model system. Treatment of S. cerevisiae with PM02734 rapidly induced necrosis-like cell death, as also found for mammalian cells treated with its close analogue kahalalide F. We have screened the complete set of 4,848 viable S. cerevisiae haploid deletion mutants to identify genes involved in sensitivity or resistance to PM02734. Forty-five percent of the 40 most sensitive strains identified had a role in intracellular vesicle trafficking, indicating that the drug severely affects this process. A mutant strain lacking the sphingolipid fatty acyl 2-hydroxylase Scs7 was found to be the most resistant to PM02734, whereas overexpression of Scs7 rendered the cells hypersensitive to PM02734. To validate these findings in human cells, we did small interfering RNA experiments and also overexpressed the Scs7 human homologue FA2H in human cancer cell lines. As in yeast, FA2H silencing turned the cells resistant to the drug, whereas FA2H overexpression led to an increased sensitivity. Moreover, exogenous addition of the 2-hydroxylated fatty acid 2-hydroxy palmitic acid to different human cell lines increased their sensitivity to the cytotoxic compound. Taken together, these results suggest that the cell membrane and, in particular, 2-hydroxy fatty acid–containing ceramides are important for PM02734 activity. These findings may have important implications in the development of PM02734 because tumor cells with high FA2H expression are expected to be particularly sensitive to this drug. [Cancer Res 2008;68(23):9779–87]
Maintenance of cardiac output with normal filling pressures in patients with dilated heart failure.
Authors: L W Stevenson, J H Tillisch
Journal: Circulation (1986)

Therapy of elevated ventricular filling pressures in patients with dilated heart failure may be limited by concern that cardiac output will be further compromised. Twenty-five patients with severe symptoms and ejection fractions of 25% or less were studied to determine the lowest ventricular filling pressures that could be achieved with vasodilator and diuretic therapy while maintaining cardiac output. In 20 of 25 patients normal pulmonary capillary wedge pressures (PCWs) were achieved (mean 10 mm Hg compared with 30 mm Hg at baseline). Stroke volume was 60 vs 39 ml at baseline. Stroke work index was 30 vs 19 g-m/m2. For each patient, over the range of PCWs, stroke volume and stroke work index were maintained and were often maximal at the lowest PCW achieved. The upright position was well tolerated in patients with normal supine PCW. Normal filling pressures can be achieved in patients with congestive heart failure without compromise of cardiac output. While congestive symptoms should be improved, the feasibility and benefit of maintaining normal filling pressures over a long term must be established.
LUPUS VULGARIS: A PLEA FOR EARLY AND ORGANIZED TREATMENT
Authors: R. Hallam
Journal: BMJ (1929)

<h3>Abstract</h3> Oral squamous cell carcinoma (OSCC) frequently metastasizes to the regional lymph nodes but only occasionally beyond. Initial phases of metastasis are associated with an epithelial-mesenchymal transition (EMT), the consolidation phase is associated with mesenchymal-epithelial transition (MET). This dynamic is referred to as epithelial-mesenchymal plasticity (EMP). To capture EMP-associated heterogeneity in OSCC, we performed single-cell RNA sequencing of 5 primary tumors and 9 lymph node metastases and analyzed publicly available data of 9 additional primary tumors for a total of 7,263 carcinoma cells. Focusing initially on one metastasis to avoid inter-patient heterogeneity as confounder, we identified OSCC cells expressing genes characteristic of different epithelial and partial EMT stages. RNA velocity information together with the increase in inferred copy number variations indicated a progressive trajectory towards epithelial differentiation. Extension to all samples revealed a less stringent but essentially similar pattern. Interestingly, the epithelial differentiation in OSCC metastases is associated with higher activity of EMT-activator ZEB1, which was confirmed by co-expression of ZEB1 and cornifin-B by immunohistochemistry. In summary, we show that EMP enables different EMT and epithelial phenotypes of OSCC cells, which are endowed with capabilities essential for the different stages of the metastatic process, including maintenance of cellular integrity.
Biased Ascertainment and the Natural History of Diseases
Authors: A. G. Motulsky
Journal: New England Journal of Medicine (1978)

The outcome of a given chronic disease is of much interest to the individual patient and his physicians. Knowledge of the natural history of untreated disease becomes particularly important in decisions regarding initiation of treatment and assessing the effect of various modes of therapy on the course of a given disease. A bias in most published data regarding prognosis and natural history of chronic disease suggests worse outcomes than actually apply. Inappropriate therapeutic decisions may result.Many chronic diseases have a wide range of clinical manifestations. Patients with more severe symptoms are more likely to find their way to physicians. . . .
Pathway for transient ischaemic attacks
Authors: A. Rudd, G. Cloud
Journal: BMJ (2010)

The results of the UK audit of vascular surgical services and carotid endarterectomy must be seen in context.1 The audit describes the care of a small subset of patients with transient ischaemic attack in the NHS—namely, those with identified symptomatic carotid stenosis. Of these, only patients with symptoms related to high grade carotid stenosis …
ESGE Guidelines for Quality Control in Servicing and Repairing Endoscopes
Authors: J-F. Rey, K. Spencer, P. Jurkowski, H-W. Albrecht
Journal: Endoscopy (2004)

In issuing guidelines on repairing endoscopes, the aim of the European Society of Gastrointestinal Endoscopy (ESGE) Guidelines Committee is to draw the attention of those who manage endoscopy units to the quality control requirements involved in having endoscopes repaired. Information on endoscope repair is important not only for medical doctors, nurses and assistants, but also for medical engineers and - even more so - for hospital administrators.
Mothering skills of women with mental illness.
Authors: S Bourne, E Lewis, S Kraemer
Journal: BMJ (1993)

been carried out for phenylketonuria since the mid-1970s and testing for hypothyroidism since the mid-'80s.Our recent data on new mothers' knowledge of these tests suggests that ignomce is widespread.As part of the Cambridge prenatal screening study, 1387 women from nine hospitals in four regions completed a postal questionnaire six weeks after giving birth.2All but eight women knew where the test had been done (1209 at home and 163 in hospital, with more primiparous women tested in hospital).Most women (951) said that the test had been fully explained and 222 "knew about it already."The extent to which women thought that they were informed, however, was not reflected in the answers to a question about which disorders this blood sample was tested for (table ).Mothers' responses to question "Which of the following was your baby testedfor?" Don't YesNo knowCystic fibrosis (n=1232)
CNTF Gene Therapy Confers Lifelong Neuroprotection in a Mouse Model of Human Retinitis Pigmentosa
Authors: Daniel M Lipinski, Alun R Barnard, Mandeep S Singh, Chris Martin, Edward J Lee, Wayne I L Davies, Robert E MacLaren
Journal: Molecular Therapy (2015)

The long-term outcome of neuroprotection as a therapeutic strategy for preventing cell death in neurodegenerative disorders remains unknown, primarily due to slow disease progression and the inherent difficulty of assessing neuronal survival in vivo. Employing a murine model of retinal disease, we demonstrate that ciliary neurotrophic factor (CNTF) confers life-long protection against photoreceptor degeneration. Repetitive retinal imaging allowed the survival of intrinsically fluorescent cone photoreceptors to be quantified in vivo. Imaging of the visual cortex and assessment of visually-evoked behavioral responses demonstrated that surviving cones retain function and signal correctly to the brain. The mechanisms underlying CNTF-mediated neuroprotection were explored through transcriptome analysis, revealing widespread upregulation of proteolysis inhibitors, which may prevent cellular/extracellular matrix degradation and complement activation in neurodegenerative diseases. These findings provide insights into potential novel therapeutic avenues for diseases such as retinitis pigmentosa and amyotrophic lateral sclerosis, for which CNTF has been evaluated unsuccessfully in clinical trials. The long-term outcome of neuroprotection as a therapeutic strategy for preventing cell death in neurodegenerative disorders remains unknown, primarily due to slow disease progression and the inherent difficulty of assessing neuronal survival in vivo. Employing a murine model of retinal disease, we demonstrate that ciliary neurotrophic factor (CNTF) confers life-long protection against photoreceptor degeneration. Repetitive retinal imaging allowed the survival of intrinsically fluorescent cone photoreceptors to be quantified in vivo. Imaging of the visual cortex and assessment of visually-evoked behavioral responses demonstrated that surviving cones retain function and signal correctly to the brain. The mechanisms underlying CNTF-mediated neuroprotection were explored through transcriptome analysis, revealing widespread upregulation of proteolysis inhibitors, which may prevent cellular/extracellular matrix degradation and complement activation in neurodegenerative diseases. These findings provide insights into potential novel therapeutic avenues for diseases such as retinitis pigmentosa and amyotrophic lateral sclerosis, for which CNTF has been evaluated unsuccessfully in clinical trials.
INTERVENTION STUDY FOR PRIMARY PREVENTION OF ORAL CANCER AMONG 36 000 INDIAN TOBACCO USERS
Authors: PrakashC. Gupta, JensJ. Pindborg, R.B. Bhonsle, P.R. Murti, FaliS. Mehta, M.B. Aghi, D.K. Daftary, H.T. Shah, P.N. Sinor
Journal: The Lancet (1986)
Phenotypic cure 6 years after bone marrow transplantation in a β-thalassemia patient
Authors: Sivan Berger‐Achituv, Michal Rothschild, Elizabeth Naparstek, Baruch Wolach
Journal: American Journal of Hematology (2009)

increase has been previously reported only in three transplanted sickle cell disease patients after graft failure [6], suggesting that such an event may occur in different genetic diseases.In the absence of a definite explanation, only a series of hypotheses can be discussed.It is possible that, after myeloablative treatment, the vast majority of committed autologous erythroid progenitors were destroyed, and autologous hematopoietic stem cells alone survived in marrow niches, restoring the ontological HbF regulation mechanisms [7] with a complete reversal of ggene silencing.In such a case, it is questionable whether this long-lasting effect on full HbF synthesis will be permanent.Otherwise, the increased HbF may be due to a new status, induced by modulations and influences operating in the setting of the BMT (microenvironment and stage-specific cytokines), able to re-program globin-gene expression or to select the ''fetal clones'' proliferation.Such a possibility is supported by the fact that the environment is known to influence globin synthesis [8].Moreover, it remains to be determined whether the favorable genetic predisposition for a deregulated g-globin gene transcription (homozygosity for Gg-158) observed in our patient concurred with the full HbF production.
A study of desmoglein 1 autoantibodies in pemphigus vulgaris: racial differences in frequency and the association with a more severe phenotype
Authors: K.E. Harman, M.J. Gratian, B.S. Bhogal, S.J. Challacombe, M.M. Black
Journal: British Journal of Dermatology (2000)

Pemphigus vulgaris (PV) is characterized by pathogenic autoantibodies to desmoglein (Dsg) 3, but additional antibodies to Dsg1, the pemphigus foliaceus antigen, are detectable in some cases.To investigate the clinical significance of the presence of both Dsg 1 and 3 antibodies.In 79 subjects with PV, enzyme-linked immunosorbent assays were used to detect IgG autoantibodies reactive with the ectodomain of Dsg1 and Dsg3.There was a clear association between the clinical phenotype and the Dsg antibody profile. All subjects had Dsg3 autoantibodies and 61% had coexisting Dsg1 antibodies (Dsg3+/Dsg1+). PV limited entirely to the mucosal surfaces was seen only in Dsg3+/Dsg1- patients, while additional Dsg1 antibodies (Dsg3+/Dsg1+) predicted cutaneous in addition to mucosal involvement. Although minor cutaneous involvement was observed in most Dsg3+/Dsg1- patients, severe cutaneous involvement was seen only in Dsg3+/Dsg1+ patients. Dsg1 antibodies were detectable early in the course of disease and their appearance did not relate to the use of systemic therapy. The proportion of Dsg1+ patients was higher in those of Indian origin compared with white northern Europeans (P < 0.05).These data suggest that the presence of Dsg1 antibodies is predictive of a potentially more severe disease and that genetic factors may determine the Dsg antibody profile.
The Role of Carotid Bruit in Screening for Carotid Stenosis
Authors: Tina T. Lee
Journal: Annals of Internal Medicine (1997)

Letters15 October 1997The Role of Carotid Bruit in Screening for Carotid StenosisTina T. Lee, MD, Paul A. Heidenreich, MD, and Neil A. Solomon, MDTina T. Lee, MDStanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612, Paul A. Heidenreich, MDStanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612, and Neil A. Solomon, MDStanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-8_Part_1-199710150-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Rea's query concerns a common, clinically important question. Published data suggest that the presence of carotid bruit is a reasonably accurate indicator of carotid stenosis in symptomatic persons. Fewer data are available with which to assess its role in asymptomatic persons. In symptomatic persons, Ziegler and colleagues [1] found a sensitivity of 0.29 and a specificity of 0.88 for detecting stenosis greater than 50%; the collaborators of the North American Symptomatic Carotid Endarterectomy Trial [2] found a sensitivity of 0.62 and a specificity of 0.61 for detecting stenosis of 70% to 99%; and Hankey and Warlow [3] ...References1. Ziegler DK, Zileli T, Dick A, Sebaugh JL. Correlation of bruits over the carotid artery with angiographically demonstrated lesions. Neurology. 1971; 21:860-5. Google Scholar2. Sauve JS, Thorpe KE, Sackett DL, Taylor W, Barnett HJ, Haynes RB, et al. Can bruits distinguish high-grade from moderate symptomatic carotid stenosis? The North American Symptomatic Carotid Endarterectomy Trial. Ann Intern Med. 1994; 120:633-7. Google Scholar3. Hankey GJ, Warlow CP. Symptomatic carotid ischaemic events: safest and most cost effective way of selecting patients for angiography, before carotid endarterectomy. BMJ. 1990; 300:1485-91. Google Scholar4. Fowl RJ, Marsch JG, Love M, Patterson RB, Shukla R, Kempczinski RF. Prevalence of hemodynamically significant stenosis of the carotid artery in an asymptomatic veteran population. Surg Gynecol Obstet. 1991; 172:13-6. Google Scholar5. Wolf PA, Kannel WB, Sorlie P, McNamara P. Asymptomatic carotid bruit and risk of stroke. The Framingham study. JAMA. 1981; 245:1442-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: Stanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFocused screening for occult carotid artery disease: patients with known heart disease are at high riskAsymptomatic Internal Carotid Artery Stenosis Defined by Ultrasound and the Risk of Subsequent Stroke in the Elderly 15 October 1997Volume 127, Issue 8_Part_1Page: 657-658 Issue Published: 15 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Dartmouth leads campaign for clinical trial transparency in the US
Authors: M. McCarthy
Journal: BMJ (2013)

Dartmouth College’s Geisel School of Medicine has become the first US academic center to join the international AllTrials campaign (www.alltrials.net) for all clinical trials to be registered and their full methods and results published.

The campaign was launched in January this year by the BMJ , the Bad Science author Ben Goldacre, the charity Sense About Science, the James Lind Alliance, and Oxford University’s Centre for Evidence-Based Medicine.1

Steven Woloshin, professor of community and family …
Duodenogastric reflux and pyloric surgery.
Authors: W B James, D A Robertson, G R Sutherland
Journal: BMJ (1972)

few warts with the drug often results in a spontaneous regression of all.We instruct all patients to wash off the paint four to six hours after its application and thereafter to apply hydrocortisone lotion 1% twice a day for several days.These two measures prevent local reactions without interfering with anti- mitotic activity.When extensive wart growths are found after the thirtieth week of pregnancy we do no more than treat any coexisting condition -for example, trichomoniasis, candidiasis, or gonorrhoea.Experience shows that even ex- tensive warts disappear spontaneously after delivery.This happened even in two cases in which intragenital and extragenital warts were so widespread that caesarian section was seriously considered.-Weare, etc.,