tbuckley/cabot-search huggingface dataset:
Evidence based reform of mental health care
Authors: Patrick D McGorry
Journal: BMJ (2005)

AIDS, Tuberculosis and Malaria, which provided grants of more than $850m, (£460m, €685m), did not focus either on assessing the impact of interventions or on a robust programme for health systems research.w4 If the global agenda to reduce the burden of disease among poor children is to progress, evidence based interventions must be accompanied by meticulous documentation of impact and a clear process for learning.This week has witnessed one of the largest assemblies of public health workers and partners at the ninth meeting of the Global Forum for Health Research in Mumbai, as well as the launch at the UN Summit in New York of the new global Partnership for Maternal, Newborn and Child Health.Both of these well intentioned events underscore the need to reduce the inequity in global child health through concerted action and appropriate research.It is now time to translate rhetoric into action.
Redistribution of left ventricular strain by cardiac resynchronization therapy in heart failure patients
Authors: Julija Klimusina, Bart W. De Boeck, Geert E.H. Leenders, Francesco F. Faletra, Frits Prinzen, Manuela Averaimo, Elena Pasotti, Catherine Klersy, Tiziano Moccetti, Angelo Auricchio
Journal: European Journal of Heart Failure (2010)
Allergen specific immunotherapy is safe and effective in patients with systemic mastocytosis and Hymenoptera allergy
Authors: Patrizia Bonadonna, Roberta Zanotti, Beatrice Caruso, Luca Castellani, Omar Perbellini, Sabrina Colarossi, Marco Chilosi, Annarita Dama, Michele Schiappoli, Giovanni Pizzolo, Gianenrico Senna, Giovanni Passalacqua
Journal: Journal of Allergy and Clinical Immunology (2008)
Why do so few patients appeal against detention under section 2 of the mental health act?
Authors: C. Bradley, M. Marshall, D. Gath
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To determine why most patients do not exercise their right of appeal against detention under section 2 of the Mental Health Act 1983. <b>Design</b>: Part one—retrospective analysis of the clinical notes of patients detained under section 2 of the Mental Health Act. Part two—interviews with patients on the penultimate day before the deadline for lodging an appeal. <b>Setting</b>: In part one, five districts in the Oxfordshire Regional Health Authority. In part two, six hospitals from three districts in the region. <b>Subjects</b>: In part one all patients detained under section 2 in the five districts in 1993 (n=418). In part two interviews with 40 patients detained under section 2 in the six hospitals. <b>Results</b>: Patients were more likely to appeal if they were educated to A level standard (odds=2.26; P=0.0014) or had had a previous admission (2.19, P=0.0029). Patients with a diagnosis of depression (0.31; P=0.015) or dementia (0.0003, P=0.0001) were less likely to appeal. Compared with those who appealed (n=12) those who did not (n=28) showed less understanding of their rights (P=0.034) and poorer comprehension of sentences from the booklet describing patients9 rights (P=0.057). The main reasons given for not appealing were not being aware of the appeals process and being deterred by having to appeal in writing. After they received a full explanation of their rights 12 of those who did not appeal said that they wished to appeal and four did so within the time remaining before the deadline. Of 40 patients, 39 said there should be an automatic right of appeal. <b>Conclusions</b>: The appeals procedure against detention under section 2 of the Mental Health Act is not a satisfactory way of protecting the civil liberties of patients. If patients were fully informed of their rights they would probably be much more likely to appeal. <h3>Key messages</h3> Key messages Among those who do not appeal about half are unaware that they have the right to do so Factors making patients more likely to appeal are education to A level standard and previous admission to a psychiatric hospital Patients who do not appeal have greater difficulty in understanding the booklet explaining their rights under the act If patients were fully informed of their rights they would probably be much more likely to appeal
Hepatitis B Outbreak Traced to an Oral Surgeon
Authors: David Rimland, William E. Parkin, Grayson B. Miller, W. D. Schrack
Journal: New England Journal of Medicine (1977)

Over a four-year period in a five-county area, 71 patients with clinical hepatitis B had dental work performed in the two to six months before their illness. Fifty-five cases were traced to a single oral surgeon. Seventy-nine per cent of these patients were positive for hepatitis B surface antigen (HBsAg) and most had no other recognized source of hepatitis. An investigation of the implicated dentist uncovered no gross inadequacies in instrument sterilization or general dental procedures; however, the dentist was found to be an asymptomatic carrier of HBsAg of the same subtype (ay) as nine of 11 of his patients who had hepatitis and whose serums were available for testing. Since no HBSAg was found in the dentist's saliva, urine or feces, and since he admitted to having frequent cuts on his fingers, it is possible that a "hemoral" transmission of HBs Ag produced hepatitis in his patients.
Primary care trust reverses decision not to fund trastuzumab
Authors: Susan Mayor
Journal: BMJ (2005)

An NHS primary care trust in England last week reversed its decision not to pay for treating a woman with early breast cancer with trastuzumab (Herceptin). It said that after further consideration and intervention by the secretary of state for health it had decided to fund the anticancer drug because of her “exceptional circumstances.”

North Stoke Primary Care Trust in Staffordshire initially rejected an appeal by 41 year old Elaine Barber to be prescribed trastuzumab, even though her specialist had recommended treatment with the drug. The trust said its decision was based on the fact that its safety and cost effectiveness was currently unconfirmed. It had said, “At this stage the evidence of this [trastuzumab] as a cost effective use of the finite health resources available for North Stoke patients is not confirmed. It would therefore be premature to agree to introduce …
Establishing educational needs in a new organisation
Authors: T. Wilson, F. Butler, M. Watson
Journal: BMJ (1998)

The creation of a new organisation requires a new collection of skills and knowledge. Its members will need an entirely novel programme of education and training. Primary care groups (PCGs) are a useful example of an organisation which needs to define its education and training needs. We asked two questions about these new organisations: “What skills and knowledge will be required?” and then “What means should be used for delivering the education and training?” The process is analogous to establishing the training needs of a new post within an organisation, though the Delphi process described below would probably be overkill for a single job.

### Stages involved in establishing the training needs of a new organisation or post

In view of the important (and daunting) tasks facing primary care groups it seemed crucial to try and establish what the education and training needs for PCGs were and to consider how they could be delivered. Although it will be …
"Pseudoleukemia" in Alcoholism
Authors: Edwin H. Poore
Journal: JAMA (1976)

<h3>To the Editor.—</h3> The existence of hematologic abnormalities secondary to alcoholism has been well documented.<sup>1</sup>Hematologic abnormalities secondary to septicemia are also known to occur, and when sepsis has occurred in chronic alcoholics, an especially severe form of leukopenia has been reported.<sup>2</sup>Bone marrow examination in these patients showed virtual absence of any granulocyte precursors except promyelocytes and myelocytes. With treatment of the infection, subsequent bone marrow examination showed rapid recovery of the granulocyte elements. A not dissimilar bone marrow picture has been described in patients recovering from drug-induced agranulocytosis, wherein the descriptive term "pseudoleukemia" was applied to the clinical situation because of the initial differential problem in a patient with anemia, thrombocytopenia, and severe leukopenia.<sup>3</sup>Because we feel that this term could be extended to include the picture of the alcoholic patient with sepsis, we report here the case of an alcoholic patient with overwhelming pneumococcal
Optimism for the future of unified theories
Authors: John R. Anderson, Christian Lebiere
Journal: Behavioral and Brain Sciences (2003)

The commentaries on our article encourage us to believe that researchers are beginning to take seriously the goal of achieving the broad adequacy that Newell aspired to. The commentators offer useful elaborations to the criteria we suggested for the Newell Test. We agree with many of the commentators that classical connectionism is too restrictive to achieve this broad adequacy, and that other connectionist approaches are not so limited and can deal with the symbolic components of thought. All these approaches, including ACT-R, need to accept the idea that progress in science is a matter of better approximating these goals, and it is premature to be making judgments of true or false.
Abstract 1809: Stimulation of antibody dependent cell-mediated cytotoxicity by interleukin-15 is equivalent to interleukin-2
Authors: Kimberly A. McDowell, Jacquelyn A. Hank, Paul M. Sondel
Journal: Cancer Research (2011)

Abstract An important strategy for the treatment of cancer involves administration of tumor-specific antibodies that target tumor cells for destruction by the individual's leukocytes via antibody dependent cell-mediated cytotoxicity (ADCC). However, ADCC is frequently depressed in individuals with cancer. Interleukin-2 (IL-2), a pro-inflammatory cytokine, enhances ADCC and is used clinically for this purpose. Interleukin-15 (IL-15) is a cytokine that shares many functions with IL-2, including stimulation of ADCC and proliferation and activation of natural killer cells. In contrast to IL-2, IL-15 supports the survival of CD8+ memory T cells, does not produce T cell activation-induced cell death and has no marked effects on Treg cells. Since these different functions may prove beneficial when using a cytokine to stimulate ADCC in vivo in cancer immunotherapy, we compared the in vitro effect of IL-15 (generously provided by Dr. Stephen Creekmore, NCI-Frederick) versus IL-2 to enhance ADCC. Using a standard 51Cr release assay, M21 human melanoma cells were loaded with 51Cr and incubated for four hours at 37° with human peripheral blood mononuclear cells (PBMC), hu14.18K322A, (generously provided by Dr. Fariba Navid of St. Jude Children's Research Hospital) a monoclonal antibody specific for GD2 (disialoganglioside) that is overexpressed on M21 cells (5 ng/ml), and either media, IL-2 (10 ng/ml) or IL-15 (10 ng/ml). The ratio of effectors (PBMCs) to targets (M21) was 10:1 or 30:1 and % cytotoxicity was determined from which lytic units were calculated. Incubation with IL-2 augmented ADCC from 163±39 to 230±40 lytic units (n=6, mean±SEM) while incubation with IL-15 enhanced ADCC from 148±27 to 229±36 lytic units (n=6). ADCC response was comparable for IL-2 and IL-15 (p=0.4857) and similar results were obtained using higher and lower concentrations of hu14.18K322A (0.1 – 100 ng/ml) and IL-2 and IL-15 (5 – 25 ng/ml), and after pre-incubation of PBMCs with IL-2 or IL-15 (4 – 44 hours). These experiments indicate that IL-2 and IL-15 demonstrate comparable stimulation of ADCC in vitro. If IL-15 produces equivalent enhancement of ADCC compared to IL-2 in vivo, it may be a potential immunotherapeutic for cancer. 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 1809. doi:10.1158/1538-7445.AM2011-1809
Leprosy masked by steroids.
Authors: J S Prendiville, J J Cream, F Clifford Rose, J T Scott, D F Woodrow, M F Waters
Journal: BMJ (1984)

Leprosy is often assumed to be rare in the Middle East.In 1975 the prevalence in Saudi Arabia, based on 460 registered cases, was 0 1 per thousand population,' a prevalence similar to that in Spain and considerably lower than that in Burma, where it is 8-6 per thousand population.We wish to alert physicians to the hazards when the diagnosis of leprosy is overlooked and steroids are administered indiscriminately.We report on a patient with leprosy receiving oral steroids in whom
TRANSIENT AND RECURRENT AURICULAR FIBRILLATION
Authors: ROSS V. PATTERSON
Journal: JAMA (1924)

The chief purpose of this communication is to direct attention to the importance of transient and recurrent auricular fibrillation of a paroxysmal character accurring in apparently healthy hearts, in moderately advanced myocarditis, and in other conditions in which the evidence of heart damage is less evident than in valvular disease. The material on which discussion has been based has been gathered from cases recorded in the literature on the subject, and from eight additional cases observed by me and here presented. Intermittent auricular fibrillation in association with frank valvular disease, having been already adequately described, is not included in the case reports. That transient form associated with auricular flutter is also excluded.  Intermittent auricular fibrillation first appeared in medical literature in 1907 in a report by Cushny and Edmunds.1They studied a single patient who had been subject to paroxysms of tachycardia with absolute irregularity over a period of
Cost-Effectiveness of Early Irbesartan Treatment Versus Control (Standard Antihypertensive Medications Excluding ACE Inhibitors, Other Angiotensin-2 Receptor Antagonists, and Dihydropyridine Calcium Channel Blockers) or Late Irbesartan Treatment in Patients With Type 2 Diabetes, Hypertension, and Renal Disease
Authors: Andrew J. Palmer, Lieven Annemans, Stéphane Roze, Mark Lamotte, Pablo Lapuerta, Roland Chen, Sylvie Gabriel, Paulo Carita, Roger A. Rodby, Dick de Zeeuw, Hans-Henrik Parving
Journal: Diabetes Care (2004)

OBJECTIVE—The aim of this study was to determine the most cost-effective time point for initiation of irbesartan treatment in hypertensive patients with type 2 diabetes and renal disease. RESEARCH DESIGN AND METHODS—This study was a Markov model–simulated progression from microalbuminuria to overt nephropathy, doubling of serum creatinine, end-stage renal disease, and death in hypertensive patients with type 2 diabetes. Two irbesartan strategies were created: early irbesartan 300 mg daily (initiated with microalbuminuria) and late irbesartan (initiated with overt nephropathy). These strategies were compared with control, which consisted of antihypertensive therapy with standard medications (excluding ACE inhibitors, other angiotensin-2 receptor antagonists, and dihydropyridine calcium channel blockers) with comparable blood pressure control, initiated at microalbuminuria. Transition probabilities were taken from the Irbesartan in Reduction of Microalbuminuria-2 study, Irbesartan in Diabetic Nephropathy Trial, and other published sources. Costs and life expectancy, discounted at 3% yearly, were projected over 25 years for 1,000 simulated patients using a third-party payer perspective in a U.S. setting. RESULTS—Compared with control, early and late irbesartan treatment in 1,000 patients were projected to save (mean ± SD) $11.9 ± 3.3 million and $3.3 ± 2.7 million, respectively. Early use of irbesartan added 1,550 ± 270 undiscounted life-years (discounted 960 ± 180), whereas late irbesartan added 71 ± 40 life-years (discounted 48 ± 27) in 1,000 patients. Early irbesartan treatment was superior under a wide-range of plausible assumptions. CONCLUSIONS—Early irbesartan treatment was projected to improve life expectancy and reduce costs in hypertensive patients with type 2 diabetes and microalbuminuria. Later use of irbesartan in overt nephropathy is also superior to standard care, but irbesartan should be started earlier and continued long term.
Kidney Transplantation from Anencephalic Donors
Authors: Wolfgang Holzgreve, Fritz K. Beller, Bernd Buchholz, Manfred Hansmann, Kurt Köhler
Journal: New England Journal of Medicine (1987)

CONSIDERATION has recently been given to whether anencephalic fetuses can appropriately be used as organ donors after birth.1 Our group has performed three successful kidney transplantations from two anencephalic fetuses, and we report the results after post-transplantation observation periods of more than 1 1/2 and 2 1/2 years, respectively.Our approach was a response to a shortage of cadaveric kidneys for transplantation in our area. We were, however, aware of a variety of ethical problems2 that had to be considered before an attempt was made to deliver anencephalic infants as organ donors for either children or adults. These problems are . . .
Hemorrhage from the Ear Due to an Aneurysm of the Internal Carotid Artery
Authors: George Ehni, John H. Barrett
Journal: New England Journal of Medicine (1960)

SHARP bleeding from an ear as a consequence of fracture of the petrous portion of the temporal bone, of neoplasm of the glomus jugulare eroding through and presenting into the external auditory canal and of carcinoma invading the ear is well known, and these conditions virtually exhaust the diagnostic possibilities in explanation of voluminous auditory-canal bleeding. In the case reported below, hemorrhage was so furious, control of the bleeding by the patient so dramatic, and origin of the bleeding so singular that a brief report is considered worth while. Possibly, a similar situation has been encountered by others, but if . . .
Anorexia Nervosa: A Somatic Disorder
Authors: E. Williams
Journal: BMJ (1958)

The results of treatment in anorexia nervosa are poor and have not benefited from its inclusion with the psychosomatic disorders (Cobb, 1950).Indeed, the approach to treatment has recently become confused owing to the mystery which now surrounds its aetiology, at one time explained in terms which, if superficial, at least were easily understood.In his original description of the disease Sir William Gull (1874) attributed the want of appetite to a " morbid mental state," claiming that its origin is " central and not peripheral," and that the state might be called " hysterical without committing ourselves to the etymo- logical value of the word, or maintaining that the subjects of it have the common symptom"s of hysteria."He described his patients as " wilful, often allowed to drift their own way into a state of extreme exhaustion," in this way clearly implying that the illness is largely self- induced.Samuel Gee (1907) described it as a melan- choly-" no more than a high degree of the melancholy which affects so many girls about the age of puberty and for somie years afterwards," arising, he said, "from a morbid excess of that craving for sympathy which is so common to all mankind, as is especially strong in the female sex."Ryle (1936), in his Schorstein Memorial Lecture, summarized the sequence of events in this way: "A psychic trauma or a foolish habit or some combination of the two results in a loss of appetite and a suppression of the menses.Starvation follows and with starvation an aggravation of the anorexia."Ryle (1936) protested that " physicians subject to the lures of endocrinology have been tempted sometimes to find a basis for the symptoms of the disease in a primary deficiency or disharmony of the internal secretions."Psychiatrists, on the other hand, have claimed the illness in all its aspects as their own.History-taking has given way to psycho-analysis; physical findings are now ignored; and treatment has been ousted by therapy, either psychotherapy or electric convulsion, or both.
Concentration-dependent effects of protein kinase C-activating and -nonactivating phorbol esters on myocardial contractility, coronary resistance, energy metabolism, prostacyclin synthesis, and ultrastructure in isolated rat hearts. Effects of amiloride.
Authors: J E Watson, M Karmazyn
Journal: Circulation Research (1991)

An extensive investigation of the cardiac actions of phorbol esters and the potential role of the Na(+)-H+ exchanger in those actions was carried out using isolated rat hearts. Sixty minutes of perfusion with 10(-9) M phorbol 12-myristate 13-acetate (PMA) or 10(-8) M phorbol 12,13-dibutyrate (PDBu) produced marked cardiac dysfunction associated with depressed contractility, coronary constriction, and elevated resting tension, the latter being particularly evident with PMA. These effects were also associated with disturbances in tissue levels of energy metabolites manifested primarily by a reduction in ATP and an elevation in lactate. Furthermore, both phorbols produced a sustained stimulation of the release of 6-ketoprostaglandin F1 alpha (6-keto PGF1 alpha), the hydrolysis product of prostacyclin (prostaglandin I2). Amiloride, an inhibitor of the Na(+)-H+ exchanger, significantly attenuated the loss in contractility and elevation in coronary pressure as well as the stimulated release of 6-keto PGF1 alpha but was without effect on elevations in resting tension or on changes in energy metabolites. Increasing concentrations of PMA or PDBu 10-fold resulted in a much more rapid and severe (greater than 80% loss in contractile function after 30 minutes) effect that was nonetheless qualitatively identical to that seen with the lower concentrations of phorbol. However, the effects were not prevented by amiloride. Surprisingly, 4 alpha-phorbol 12,13-didecanoate (alpha-PDD, 10(-6) M), which does not activate protein kinase C, was found to be a potent inhibitor of cardiac function (greater than 80% loss in contractility and 50% increase in resting tension) after 30 minutes of perfusion, although these effects were not associated with changes in levels of energy metabolites or with elevations in coronary pressure. Similarly, none of the actions of this compound were attenuated by amiloride. In contrast to the sustained effects of other phorbols on 6-keto PGF1 alpha release, the effect of alpha-PDD was transient (less than 10 minutes). In all hearts studied, the marked depression in contractile function caused by all phorbol esters occurred in the absence of any ultrastructural changes. 4 alpha-Phorbol (10(-6) M), which does not activate protein kinase C, was without effect on any parameter studied. Our results demonstrate very complex effects of phorbol esters on numerous parameters of cardiac function, including an amiloride-sensitive component that occurs at low concentrations. The latter observation suggests the involvement of Na(+)-H+ exchange activation, possibly occurring as a consequence of protein kinase C stimulation, in mediation of the effects of phorbol esters at low concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)