tbuckley/cabot-search huggingface dataset:
Trauma life support in conflict
Authors: J. Clasper
Journal: BMJ (2003)

Resources must be optimised for the many, rather than dispersed for the few 

War injures and kills combatants and civilians. Medical resources are usually scarce in combat zones, and doctors must plan to make the most of these resources to minimise death and suffering. Planners seek to apply the widely adopted principles of advanced trauma life support to the treatment of penetrating wounds, burns, and other forms of acute physical trauma on the battlefield. This recognises the critical importance of effective early resuscitation after wounding to minimise the consequences of shock and to improve survival.

Mortality after civilian trauma has been described as having a trimodal distribution.1 The first peak of deaths occurs within minutes of the event from non-survivable injuries, even with the most advanced medical resources immediately to hand. The second peak may account for some 30% of deaths, in the first few hours after injury. Death is most often due to hypoxia and hypovolaemic shock.2 This group stands to benefit the most from excellence in trauma care. The third peak, of up to 20% of trauma deaths, occurs late after the injury, from sepsis, multi-organ failure, and other complications.

Does this descriptive …
Half of English hospital doctors fear raising concerns, finds survey
Authors: Z. Kmietowicz
Journal: BMJ (2013)

A survey of more than 800 doctors working in hospitals in England indicates that the days of an open culture in the NHS are still a long way off, after nearly half the respondents (46%) said that they were fearful of the personal consequences of raising concerns.

The survey, conducted by the medical indemnity provider the Medical Protection Society, found that 40% of respondents had little or no confidence that recent inquiries into failings in the NHS would have a positive effect on the culture of their hospital trust.

The survey was sent in November by email to 12 000 hospital doctors in …
Duration of acetowhitening as a novel objective tool for diagnosing high risk neoplasia in Barrett's esophagus: a prospective cohort trial
Authors: G. Longcroft-Wheaton, J. Brown, P. Basford, D. Cowlishaw, B. Higgins, P. Bhandari
Journal: Endoscopy (2013)

<b>Background and study aims:</b> Acetic acid reacts with Barrett's mucosa to produce acetowhitening which disappears with time. The clinical significance of this is unknown. We aimed to quantify the acetowhitening time, developing an objective tool for diagnosis of neoplasia in Barrett's esophagus. <b>Patients and methods: </b>Prospective cohort study in a tertiary referral center, enrolling patients undergoing surveillance of Barrett's metaplasia or referred with suspected neoplasia. Acetic acid 2.5 % was applied to the mucosa via a spray catheter. Acetowhitening was observed and time to disappearance recorded. Targeted biopsies of any neoplasia and quadrantic 2-cm biopsies of residual Barrett's area were then taken. Histological findings were investigated in relation to duration of acetowhitening. <b>Results:</b> 132 patients were examined. A receiver operating characteristic (ROC) curve was produced for identifying high risk neoplasia according to acetowhitening duration. The area under the curve (AUC) was 0.93 (0.89 – 0.97). Using a threshold of 142 seconds yielded a sensitivity for neoplasia of 98 % (95 % confidence interval [95 %CI] 89 % – 100 %) and specificity of 84 % (74 % – 91 %). The ROC curve for mucosal neoplasia (high grade dysplasia or intramucosal carcinoma) versus deep invasive cancer showed an AUC of 0.786 (0.61 – 0.96); a cutoff of 20 seconds yielded a sensitivity and specificity for invasive cancer of 67 % (35 % – 90 %) and 85 % (69 % – 95 %), respectively. <b>Conclusion: </b>The time to disappearance of acetowhitening can serve as a simple but very sensitive tool for the diagnosis of high risk neoplasia in Barrett's esophagus. It can be used to distinguish mucosal neoplasia from deep invasive cancer.
When To Discuss Advance Directives
Authors: Mark S. Litwin
Journal: Annals of Internal Medicine (1993)

Letters15 March 1993When To Discuss Advance DirectivesMark S. Litwin, MDMark S. Litwin, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-6-199303150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Neubauer correctly points out that a discussion of advance directives was omitted in the management of this patient [1]. Because the surgery was so minor, it was hard to imagine such untoward consequences and easy to overlook this important part of her care. This illustrates the need for such discussions, particularly with the elderly or the severely infirm, regardless of the simplicity of the planned intervention. In addition to approaching her family about an advance directive, we might also have attempted to discuss the issue with the patient herself. Despite her mild dementia and expressive dysphasia, she ...REFERENCE1. Litwin MS. Ode to Joy. Ann Intern Med. 1992; 117:337. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 1993Volume 118, Issue 6Page: 475-476KeywordsDementiaElderlySurgeonsSurgery Issue Published: 15 March 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Efficient and Persistent Splice Switching by Systemically Delivered LNA Oligonucleotides in Mice
Authors: Jennifer Roberts, Enzo Palma, Peter Sazani, Henrik Ørum, Moo Cho, Ryszard Kole
Journal: Molecular Therapy (2006)

Locked nucleic acid (LNA) oligomers were found to be very effective in their ability to modulate alternative splicing in vivo in transgenic mice that ubiquitously express a modified EGFP pre-mRNA containing an aberrantly spliced beta-globin intron (IVS2-654). Following intraperitoneal injections, the splice-switching oligonucleotide LNA SSO-654 targeted to the aberrant 5' splice site in EGFP-654 pre-mRNA corrected aberrant splicing and increased production of repaired EGFP mRNA mainly in the liver, colon, and small intestine. Little or no effect was detected in heart, lung, or kidney, the organ where most of the oligonucleotide was distributed after four consecutive daily injections. In the liver, LNA SSO-654 had an EC(50) of 3 mg/kg, approximately 17-fold more potent than its 2'-O-methyl congener. Moreover, in the liver, colon, and small intestine oral doses of 50 mg/kg resulted in detectable levels of splice switching. The effects of four daily injections at 25 mg/kg persisted for up to 29 days but did not result in liver toxicity. The results indicate that the LNA backbone confers sequence- and organ-specific functional biodistribution of the oligonucleotides and that these potent compounds have the potential to be safe and long-acting modulators of diseases treatable by splicing manipulation.
Transfer of Heightened Immunity to Skin Homografts by Lymphoid RNA *
Authors: John A. Mannick, Richard H. Egdahl
Journal: Journal of Clinical Investigation (1964)

Prior studies from this laboratory have indi- cated that previously unstimulated lymph node cells may be altered to a state resembling trans- plantation immunity by incubation in vitro with ri- bonucleic acid (RNA) extracted from specifi- cally sensitized lymph nodes (2, 3).The assay of transplantation immunity used in these experi- ments was the transfer reaction of Brent, Brown, and Medawar (4), which is a delayed inflammatory reaction in the skin produced by the intradermal injection of immune cells into the animal against which the anticipated immune response is directed.Our finding that lymphoid RNA from an immunized animal may confer upon otherwise unsensitized lymph node cells the capacity to produce a transfer reaction has been confirmed by Clarke and Wilson (5) and more recently by others (6, 7).However, the transfer reaction may be criticized as a test for transplantation immunity.It is pos- sible by gross inspection to confuse the transfer re- action with other less specific inflammatory re- sponses in the skin.Moreover, while reports from Brent, Brown, and Medawar (4), from Dvorak and Waksman (8), and from this laboratory (2, 3, 9) have demonstrated adequately the associa- tion between the production of a transfer reaction and the state of transplantation immunity, there is no conclusive evidence that the capacity to produce a transfer reaction is equivalent to the capacity to manifest transplantation immunity in
Emphysema-like Changes in HIV
Authors: Hamid Sahebjami
Journal: Annals of Internal Medicine (1992)

Letters15 May 1992Emphysema-like Changes in HIVHamid Sahebjami, MDHamid Sahebjami, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-10-876_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:Reports of emphysema-like changes in the lungs of human immunodeficiency virus (HlV)-infected patients, as in the cases reported by Diaz and colleagues (1), are very intriguing because they occur in young and middle-aged persons, some with no history of lung disease or smoking. What is missing is information about the nutritional status of these patients. We reported in 1981 that food restriction alters lung structure and function in experimental animals and leads to morphologic, morphometric, and physiologic changes similar to those known to occur in emphysema (2). Subsequent reports from other laboratories confirmed our findings, and this...References1. DiazClantonPacht PTE. Emphysema-like pulmonary disease associated with human immunodeficiency virus infection. Ann Intern Med. 1992;116:124-8. LinkGoogle Scholar2. SahebjamiWirman HA. Emphysema-like changes in the lungs of starved rats. Am Rev Respir Dis. 1981;124:619-24. MedlineGoogle Scholar3. EdelmanRuckerPeavy NRH. Nutrition and respiratory system: chronic obstructive pulmonary disease. Am Rev Respir Dis. 1986;134:347-52. MedlineGoogle Scholar4. SahebjamiDomino HM. Effects of starvation and refeeding on elastase-induced emphysema. J Appl Physiol. 1989;66:2611-6. CrossrefMedlineGoogle Scholar5. SteinFenigstein JH. Anatomie pathologique de la maladie de famine. In: Apfelbaum E, ed. Maladie de famine. Recherchers Clinique sur la Famine Executees dans le Ghetto de Varsovie en 1942. American Joint Distribution Committee; 1946:21-7. Google Scholar1. DiazClantonPacht PTE. Emphysema-like pulmonary disease associated with human immunodeficiency virus infection. Ann Intern Med. 1992;116:124-8. LinkGoogle Scholar2. WyngaardenSmith JL. Cecil Textbook of Medicine. 18th ed. Philadelphia: W.B. Saunders; 1988:1208-11. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Veteran Affairs Medical Center Cincinnati, OH 45220 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCellular signalling pathways mediating the pathogenesis of chronic inflammatory respiratory diseases: an updateTobacco use and nicotine dependence among HIV-infected and uninfected injection drug usersEffect of Cigarette Smoking on HIV Acquisition, Progression, and MortalityMolecular pathogenesis of emphysemaPathogenesis of COPD 15 May 1992Volume 116, Issue 10Page: 876-876KeywordsEmphysemaFoodHIVLungsMorphometryNutrition Issue Published: 15 May 1992 PDF DownloadLoading ...
Jefferson Medical College Faculty Caricature
Authors: Harry M. Salzer
Journal: JAMA (1970)

<h3>To the Editor:—</h3> Probably 50 physicians are writing to you about the April 27, 1970, cover, reported as caricatures of the members of the 1923 medical faculty at Jefferson by the late Carl E. Miksch, when a medical student there. It is not surprising that other drawings by Dr. Miksch are not known, because this caricature is a plagiarism of those by A. Barrère (1912) showing the Professors of the Faculty of Paris. Dr. Miksch simply transposed some of the figures in the original caricature and put the faces of the Jefferson faculty on the bodies of the Paris faculty. Apparently Dr. Miksch was far advanced in the field of organ transplantation.
RAPID SCREENING FOR ΔF508 DELETION IN CYSTIC FIBROSIS
Authors: G.R. Taylor, J.S. Noble, J.L. Hall, P. Quirke, A.D. Stewart, R.F. Mueller, Hans Scheffer, Edwin Verlind, Dirk Penninga, Gerard Te Meerman, LeoTen Kate, Charles Buys, C.G. Mathew, R.G. Roberts, A. Harris, D.R. Bentley, M. Bobrow
Journal: The Lancet (1989)
Alexander German McKnight
Authors: W. Jackson
Journal: BMJ (2002)

Former general practitioner Belfast (b 1927; q Belfast 1950; DObst RCOG, FRCGP), d 30 August 2002.

After preregistration posts, Lexie went into practice with his brother John. The practice had a registered nurse and secretary, unusual at that time, and was the first in Northern Ireland to operate an appointments system. Long before desktop computers were available Lexie carried out research and audit by sending data to the Royal College of General Practitioners' research unit in Birmingham. The practice eventually had four partners and moved to a purpose built health centre. Lexie was at the forefront of major changes in the postgraduate education of doctors in the 1960s and 1970s. He leaves a wife, Betty; two children; and six grandchildren.
Advances in Diabetic Retinopathy Could Save Sight, Money With More Frequent Eye Exams
Authors: Paul Cotton
Journal: JAMA (1990)

EYE EXAMINATIONS every 6 months, it is argued, could save millions of dollars by detecting diabetic retinopathy before damage becomes irreversible. "If the federal government provided funds to screen and treat patients who have diabetic eye disease, the actual cost to taxpayers in the long run would be far less" than paying for the disability of blindness, says Jonathan C. Javitt, MD, MPH, assistant professor of ophthalmology, Georgetown University School of Medicine, and associate director, Worthen Center for Eye Care Research, Washington, DC. He presented the analysis at a Research to Prevent Blindness seminar in Universal City, Calif. The Georgetown study is expected to boost American Academy of Ophthalmology and National Eye Institute efforts to persuade physicians and patients to act on proven advances in preventing this leading cause of blindness among working-age Americans. Another, very preliminary, study presented at the seminar suggests that antihistamines may prevent the process that
INFLUENCE OF DIETARY FACTORS AND SEX ON THE TOXICITY OF CARBON TETRACHLORIDE IN RATS
Authors: Paul György, Joseph Seifter, Rudolph M. Tomarelli, Harry Goldblatt
Journal: The Journal of Experimental Medicine (1946)

Six groups of rats on different diets were exposed to the inhalation of carbon tetrachloride (about 300 p. p. m.) for 150 days. Food intake and changes in weight were followed throughout the experiment. Animals fed a diet low in protein showed greater susceptibility than rats on a diet high in protein. Methionine was a good substitute for protein (casein) in the diet. Increase in fat intake with correspondingly lower carbohydrate intake exerted a harmful effect, especially evident in combination with a low protein diet. In this change of the fat: carbohydrate ratio, whether the increased fat or the lowered carbohydrate is the specific factor must remain unanswered at the present time. Necrotizing nephrosis was the presenting sign of the intoxication caused by carbon tetrachloride, in addition to hepatic changes, such as hydropic degeneration, necrosis, and cirrhosis. Dietary factors (methionine and methionine-containing protein, as well as low fat intake) more consistently prevented renal injury than cirrhosis of the liver. Under identical dietary conditions, especially with higher fat intake, male rats appeared to evince greater susceptibility to carbon tetrachloride than female rats. The significance of this observation and its wider applicability has been discussed.
Confidentiality Versus the Duty to Protect: Foreseeable Harm in the Practice of Psychiatry
Authors: David I. Joseph
Journal: JAMA (1991)

In 1974 American psychiatry was rocked by the now-famous<i>Tarasoff</i>decision, which held that psychotherapists had a duty to warn potential victims of violence. The immediate ramifications for maintaining the boundaries of confidentiality were many. In 1976 the case was reheard, and the new ruling emphasized the therapist's use of professional judgment and broadened the therapist's responsibility to include a duty to protect and not merely a duty to warn the victim. Since then,<i>Tarasoff</i>has been the basis for rulings on a therapist's duty to protect, not only in cases involving a threatened victim, but also in situations in which an individual who had never been threatened was killed and one in which a man burned a barn after threatening to do so. The conflict between a patient's right to confidentiality and a therapist's duty to protect the community from foreseeable harm is the focus of this compact, well-edited,
Abstract 3210: Profiling of DNA methylation signature for different phases of prostate cancer development
Authors: Michelle Chang, Natalia Liem, Liang Kee Goh, Emarene Kalaw, Pei Li Lim, Carla Geronimo, Allen Sim, Hong Hong Huang, Tsung Wen Chong, Puay Hoon Tan, Richie Soong, Christopher Cheng, Hong Gee Sim
Journal: Cancer Research (2011)

Abstract Prostate cancer is the third most common cancer in Singaporean men. Compared to Western countries, the prostate cancer incidence is lower in Asian countries but recent data suggest that incidence is increasing, especially in rapidly urbanized countries. Recent studies provide evidence that methylated genes can be useful and promising molecular biomarkers for detection of prostate cancers. The aim of our study is to identify a panel of global gene methylation signatures that are unique and specific for different phases of prostate cancer development and different prostate cancer phenotypes. This may thus differentiate cancers from non-cancers, and aggressive cancers from indolent ones. We have profiled methylation of genes using the Illumina's GoldenGate Methylation System. The Standard GoldenGate Methylation Cancer Panel I (Illumina Inc, San Diego, CA) spans 1,505 CpG loci selected from 807 genes that have been shown in literature to play important roles in cancer. Methylation levels of candidate genes were quantified in 28 benign tissues without prostate cancer, 52 tissues of Gleason score 3+3, 66 tissues of Gleason score 4+x and 37 tissues of Gleason score 5+x. DNA used for the assays were obtained from laser capture microdissected paraffin embedded archival tissues. Interestingly, our results showed that 28 different CpG loci were methylated in Gleason 3+3 prostate cancer tissues compared to benign prostatic hyperplasia tissues that were used as controls. In addition, methylation levels in prostate cancer samples of high Gleason index (4+x and 5+x) were significantly higher than the paired prostate cancer samples of low Gleason index (3+3) in at least 10 candidate genes. These genes include VIM (p-value 3.59E-08), ASCL2 (p-value 1.71E-09), DAB2IP (p-value 6.55E-08) and FRZB (p-value 6.44E-08). Together with bioinformatics and quantitative methylation-specific PCR, we identified a set of potentially phenotype-specific gene methylation signatures in Asian men. Our studies contributed to the improvement of diagnostic capability for prostate cancer beyond available tumour markers such as PSA as it is a more sensitive molecular correlate. 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 3210. doi:10.1158/1538-7445.AM2011-3210
Exercise, health, and medicine.
Authors: I Graham, R Mulcahy, N Hickey, G Bourke
Journal: BMJ (1983)

many of his 109 ulcers had the scars of previous communicating vein operations or how many had phlebographic evidence of appreciable deep vein damage and how many recurrences there were in this particular group.In our experience popliteal reflux detected by Doppler ultrasound does not equate with post-thrombotic damage.
PBDEs: Sjödin’s Response
Authors: Andreas Sjödin
Journal: Environmental Health Perspectives (2004)

Mercury Levels in MothersI read with great interest the excellent article by Mahaffey et al. (2004), which further describes the characteristics of the 1,709 women from the National Health and Nutrition Examination Survey (NHANES) 1999-2000 who were sampled for total and organic mercury levels in blood.It adds valuable detail to the initial report published last year (Schober et al. 2003).I would appreciate clarification on one important point: in the "Discussion," the authors cited a new analysis which indicates that the cord blood:maternal blood ratio is not 1:1 as assumed by the National Research Council (NRC) in 2000 (Committee on the Toxicological Effects of Methylmercury 2000), but rather 1.7:1.Using the same benchmark dose lower limit and uncertainty factor used by the NRC, Mahaffey et al. ( 2004) calculated that blood total mercury levels > 3.5 µg/L in mothers could be associated with increased risk to the developing fetal nervous system.I am very interested in the details of this analysis and particularly in understanding why the uncertainty factor applied by the NRC to account in part for toxicokinetic variability does not compensate for uncertainty related to the cord blood:maternal blood mercury ratio.This is a critical concept because it has a dramatic impact on how many women may carry mercury levels in excess of what is believed to be safe for a fetus.
Disclosure of financial competing interests in randomised controlled trials: cross sectional review
Authors: C. P Gross
Journal: BMJ (2003)

Financial relationships among industry, investigators, and academic institutions are growing increasingly complex, raising concerns about sponsors' considerable and perhaps inappropriate involvement in the conduct and reporting of biomedical research. 1 2Medical journals use disclosure as a primary mechanism for managing these conflicts, and many have adopted the 1997 uniform requirements for manuscripts submitted to biomedical journals to guide this process. 3 According to the 1997 uniform requirements, authors are asked to "acknowledge in the manuscript all financial support for their work." 3For industry support for specific projects, authors are asked to describe the sponsor's role in the design, analysis, and reporting of the study data. 3 If there has been no such involvement, the manuscript is expected to explicitly state this fact. 3 Previous work has shown that many published papers do not contain statements of financial competing interests. 4However, little is known about journals' adherence to other parts of the disclosure guidelines or about the nature of the interests that are being disclosed.We performed a cross sectional explicit review of published randomised controlled trials in five high impact medical journals to assess adherence to all the 1997 disclosure requirements and to document the specific nature of the disclosed interests.